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m  ^^i 


VoL  V. 


AUGUST.  J905 


No*  5 


DETROIT  MEDICAL 


JOURNAL 


a77 


The  Practitioner's  MoniM?  Sa  1931 


CONTENTS; 


m* 


ORIGINAL 


Recipients  of  the  Nobel  Prize  in 
Physiology  and  Medicine :  Alfred 
Bernard  NobeL  By  Edwin  S. 
Sherrill,  M.  D.,  Detroit       -       145 

Emil  Adolph  Behring,     By  Guy  L. 

KiEFER,  M.  D.,  Detroit     -        -  148 

Etiology  of  Diabetes.  By  Spencer 
C.  DicKERsoN,  M.  D.,  New  Bed- 
ford, Mass.  -        -        -  J50 

A  Case  of  Diabetes  Insipidus.    By  M . 

A.   Fechheimer,    M.    D.,  Detroit  155 

Report  of  Cases.  Dr.  Metcalf's 
Clinic.  XII.  Fibroid  of  Uterus. 
Metritis.  XIII.  Extensive  ob- 
structing fibro-lipohna  surround- 
ing the  rectum  and  sigmoid 
flexure  XIV.  Obstruction  of 
cystic  duct  by  enlarged  lymph- 
gland.  XV.  Congenial  partial 
atresia  of  anus.  Phimosis.  XVI. 
Cholecystitis  and  chronic  pan- 
creatitis. XVII.  Fecal  fistula. 
Sponge  in  abdomen         -        -       J57 

Aneurysm  from  Bullet- Wound.      By 

G.  L.  Gruickshank,  M.  D., 
Windsor,  Ont.,  and  P.  M.  Hickey, 
M.  D.,  Detroit        -        -  J62 

Case  of  Myoclonus  Multiplex.     By 

W.  J.  Stapleton,  Jr.,  M.  D., 
Detroit        _        _        -        -  J63 


EDITORIAL 
An  Opportune  Epidemic        -  164 

Public  Schools  and  Medicine  J  65 


The 

Nothnagel  and  Miculicz 

Diabetes  Insipidus 


166 
166 


EDITORIAL  NOTES 

New  Appointment  -        -        -  172 

Association    of    Military    Surgeons  172 
International  Medical  Congress    -       J 72 


MEDICAL  PROGRESS. 
Dr.  Osler*s  Farewell  Address        -       174 
Uveitis  and  Sinus  Disease         -  174 

Feeding  Hungry  School  Children  175 
Splenomedullary  Leukemia  -  -  175 
Mortality^  Disability  and  Permanen- 
cy of  Cure  in  Sugery  -  -  175 
Carpol,  Scaphoid  and  Semilunar  -  175 
Foreign  Bodies  in  the  Eye  -  J  76 
Prostitution     -        -        -        -        -  176 


167 
168 


Therapeutic  Notes 

News         -        _        _        -        . 

New  Instruments  and  Devices 

Invalid  Elevator— New   Douche 
Point.         -        -        -        -        -  171 
Book  Reviews 

Drink  Restriction,  Von  Noorden 
— Historical  Relations,  AII- 
butt — Materia  Medica,  EUing- 
wood — Gynecologic  Diagnosis, 
Findley — New  Pharmacopoeia       179 


Published    Monthly    by 
THE  DETROIT  MEDICAL  JOURNAL  COMPANY 

103-105  Miami  Ave. 

DETROIT,  MICH.,  U.  S.  A. 


(Entered  at  the  Post  Office  at  Detroit,  Mich.,  as  second-class  matter.  May,  9th,  I90t) 


;i 


BOVININE 

in  ANiCMIA 


B 


b222S 


OVININE  overcomes  Anc^mia  logically,  rationally 
and  radically,  for  several  substantial  reasons: 

1.  Because  it  supplies  the  starving  or- 
ganism witH  the  requisites  for  immediate 
reparation. 

2.  Because  it  needs  no  preparation  or 
transformation  at  the  hands  ,  of  the  vital 
machinery  before  it  can  be  assimilated  and 
converted  into  living  force.  Scores  of  theo- 
retically excellent  foods  lack  this  vital  con- 
dition, and  are  therefore  appealed  to  in  vain. 

3.  Because  the  condition  called  Ancsmia 
results  from  a  form  of  malnutrition  which  is 
not  caused  by  lack  of  any  nutritive  element, 
but  by  the  absolute  inertia  of  the  digestive 
function. 

BOVININ£  comes  to  the  rescue  by  supplying  a 
vitalized  and  perfectly  compounded  pabulum  that  calls  for 
no  chemico-vital  effort  or  expenditure  whatever. 

Have  we  made  the  contrast  between  BOVININE 
and  all  the  rest  of  the  prepared  foods  distinct  enough  ? 

If  not,  please  apply  the  crucial  test — clinical  use — at 
our  expense,  and  convince  yourself  that  our  claims  are 
neither  extravagant  nor  exaggerated,  but  are  strictly  based 
on  science. 

THe   Bovinine  Company 

75    >Vest  Houston    Street,    NEW   YORK 


DETROIT    MEDICAL    JOURNAL 


I 


PRO  PHYL  AXIS— The  very  nature  of  artiSciar 
foods  and  cow's  milk  predisposes  to  their  rapid 
decomposition.  A  few  drops  of  Glyco  Thy- 
moline  added  to  each  feeding  corrects  acidity 
and .  prevents  disorders  of  stomach  and  intes- 
tines. 


I 


TREATMENT— As  an  adjunct  to  your  treat- 
ment of  summer  complaints,  Glyco-Thymoline 
used  internally  and  by  enema  corrects  hyper- 
acid conditions,  stops  excessive  fermentation 
and  prevents  auto  intoxication.  It  is  soothing— 
alk^line-r-nontoxic. 


SIMMER   COMPLAINT 


KRESS   &.  OWEN   CO. 


210  FULTON    ST.,  N.  Y. 


HOS;  CHRISTY  &  CO  ,  4.  10  4  12  Swan  Lane,  loi 


II 


DETROIT    MEDICAL    JOURNAL 


■  m^^^^^^ 

Morrison's  : 
Surgical 
Pad  . . 

The  Best 

Most  Convenient ; 

and 

Most  Practical 

^ 

'■■  ^s^m^^^^ 

TheDavi* 

ison  Rubber  Co. : 

>  Milk  street, 
OSTON,  MASS. 

►>.♦.».».».».».♦.♦.♦.».».♦■♦.♦.♦■♦.♦.♦•♦■♦ 

DETROIT    MEDICAL    JOURNAL 


lU 


MARR5^'   ARTIFICIAL   LIMB5 

WITH  rubbe:r  hands  and  feet 

THE    MOST    COMFOICTABLC:,     DURA.BI.C:    AND    NATUR.AL 


Althoug-li  a  man  may  lose  both  his  legs,  he  Is  not 
necessarily  helpless.  By  using  artificial  legs  with 
rubber  feet  attached,  he  can  be  restored  to  useful- 
nes&.  One  of  these  engravings  is  from  an  in- 
stantaneous photograph  of  a  man  ascending  a 
ladder.  He  has  two  artificial  legs  substituting  his 
natural  ones  which  were  crushed  in  a  railroad 
accident  and  amputated.  With  his  rubber  feet  he 
can  ascend  or  descend  a  ladder,  balance  himself 
on  the  rungs,  and  have  his  hands  at  liberty.  He 
can  work  at  a  bench  and  earn  a  good  day's  wages. 
He  can  walk  and  mingle  with  persons  without  be- 
traying his  loss:  and  in  fact  he  is  restored  to  his 
former   self   for   all    practical   purposes. 

With  the  old  method  of  complicated  ankle  joints, 
these  results  could  not  be  so  thoroughly  attained. 

Over  31,000  in  use,  scattered  in  all  parts  of  the 
world.  Many  of  these  have  been  supplied  without 
the  wearers  presenting  themselves  to  us,  simply 
sending  masurements  on  a  measuring  sheet  which 
anyone   can  easily   fill   out. 


Received  42  iligKest  A-wards.  PurcHased  by 
tKe  United  States  Goveraxnent  and  mwktiy  foreign 
governments. 

A  MANUAL  of  Artificial  Limbs  and  illustrated  measuring  sheet  sent  free  upon  applica- 


A.    A.    MARKS,    701    Broadway,    New    York     City, 

KSTABI^ISHBD    52    YKAV.S 


r^ 

hmm,^ 

Rochester  Instrument 

And    Dressing:    Sterilizer 

l  J 

l^cl 

Oxxr  Combination  Sterilixer  is  tHe    embodi- 
ment   of  \»tility,    convenience    and    practical 
adaptation  to  tKe  svirgeon'a  daily  needs. 

STEAM,  HOT  AIR.  BOILING  WATER 
may  be  utilized  at  -will.     Can  be   Heated  on 
any  Kind  of   a   stove.      Used  by    pHysiciaas 
end  Hospitals  every^rHere.    Send  for  Cat. 

*f'-^-         '~^M 

^■^..^ 

^^ 

Vilmot  Castle  Co.  Rochester  NYJ  j 

PAS-AVEN  A 


SOPORIFIC 
SED ATI  V  E 
AN  O  D Y  N   E 


POWERFUL,   BUT  ABSOLUTELY  HARMLESS 


Contains  No  Morphine  or  Opiates,  Chloral,  Bromides,  Sulphonal  or  Paraldehyde. 
Introduced  as  a  substitute  for  the  many  injurious  narcotics  and  antispasmodics  in  gen- 
eral use.  Possesses  a  pronounced  specific  action  as  a  nerve  sedative  and  hypnotic. 
Insures  nerve  tranquility  and  induces  a  calm  neural  equilibrium.  Invaluable  in  Insom- 
nia,  Hysteria,  Neurasthenia,  Convulsions,  Epilepsy,  Tetanus,  Chorea,  Spasmodic  Asth- 
ma, Neuraigia,  Alcohoiism,  IVIorphine  or  Opium  Habit,  and  All  conditions  resulting 
from  Impaired  Nerve  Function. 

DOSE— Teaspoonful,  repeat  half-hourly  if  necessary.  Children  In  proportion  to  age.  Where 
immediate  actfcn  is  required  a  dessertspoonful  or  tablespoonful  may  be  administered  at  a 
single   dose   with  safety. 

Literautre    and   sample   sent  prepaid  to  physicians  upon  request. 

PAS-AVENA  CHEMICAL  CO.  dept.  p.      223  E.  soth  St.,  new  york,  u.  s.  a. 


IV 


DETROIT    MEDICAL    JOURNAL 


REASON 

Just  cause  for  action. — Webster. 

The  high  esteem  in  which  ERGOAPIOL  (Smith)  is  held  by  all  cal- 
culating clinicians  needs  no  speculative  explanation.     It  is  due  to  no 
Dther  cause  than  that  of  REASON. 

REASON  guides  the  selection  of  each  agent  embraced  in  the  remedy; 
REASON  dictates  the  methods  by  which  their  absolute  purity  is  attained; 
REASON  prescribes  the  proportions  in  which  they  are  presented,  and 
REASON  appoints  the  cases  in  which  the  remedy  may  be  employed 
with  absolute  certainty  of  satisfying  results. 

Amenorrhea  yields,  with  almost  incredible  promptness,  to  the  curative 
properties  of  Ergoapiol  (Smith)  for  the  REASON  that  the  collabora- 
tive efforts  of  its  components  at  once  institute  functional  activity. 

Dysmenorrhea  is  relieved  by  the  administration  of  Ergoapiol  (Smith) 
for  the  REASON  that  the  remedy  possesses  marvelous  tranquilizing 
properties  despite  the  fact  that  it  contains  no  narcotic  drugs. 

Menorrhagia  invites  the  employment  of  Ergoapiol"'' (Smith)   for  the 
REASON  that  the  remedy  restricts  the  flow  to  normal  limits. 

Physicians  prefer  Ergoapiol  (Smith)  to  all  other  agents  of  a  similar 
character  for  the  REASON  that  it  is  unquestionably  the  most  depend- 
able preparation  ever  designed  for  the  relief  of 

Irreg'ular    Menstruation 

DOS£:   One  to  two  cap- 
sules 3  or  4  times  a  day. 
NOTE.— To  obviate  substit- 
ution it  is  advisable  to  order 
in  Original  Packages  only. 
Original    Package    contains 
20  capsules. 

MARTIN  H.  SMITH  CO. 

NEW  YORK,  N.  Y. 

* 

DETROIT    MEDICAL    JOURNAL 


GEBAUER'S 

Ethyl  Chloride  C.  P. 


This  Tube 

Actually  Sprays 

the  Liquid 


(absolutely  chemically  pure) 


40  Gram  Tubes 

Refilled  for 

85  Cents 


EVER  READY    LOCAL    ANESTHETIC    perfectly  harmless 


40  GRAM  Tube,  .  -  -  -  $1.00 
40  GRAM  TUBE  IN  LEATHER  CASE,  1 .25^ 
40  GRAM  EMPTY  TUBES  REFILLED,         .85 


This  tube  actually  sprays  the  liquid  in  the  form  of  a  stream, 
thereby  hastenes  evaporation  and  produces  anesthesia  in  less  than 
30  seconds,  using  one-tenth  the  liquid  used  by  other  tubes 
projecting  the  liquid  in  a  jet  stream.  By  means  of  this  spray  the 
operator  can  hold  the  nozzle  one  inch  from  part  to  be  anesthetized 
and  no  liquid  will  accumulate  or  run  to  waste,  but  evaporates  as  soon 
as  it  strikes  the  surface. 

40  GRAM  TUBE,  $1.00 


LEAKAGE 
BREAKAGE 
WASTE 
CLOQQINQ 


40  GRAM  TUBE  IN  LEATHER  CASE,  $1.25 


Manufactured  by 


The  Qebauer  Chemical  Co., 

1-5  Fleet  St.,  CLEVELAND  O. 


The..., 

Detroit 

Surgical 

Table 

NEAT, 

COMPACT, 

DURABLE. 

Made  of  highly  polished  oak,  70  inches  long  and  24  inches  wide.  When  head  and  foot 
extensions  are  lowered,  the  table  is  36  inches  long.  It  Is  suitable  for  surgical  and 
gynecological  work. 

An  extension,  sliding  out  on  either  side  of  the  table,  forms  rests  for  the  arms  or  for  in- 
struments. Stirrups  are  adjustable  to  three  lengths.  Casters  are  under  the  head  to 
facilitate  moving. 

PR.ICE,  $12.50.  NET. 

The  J.  F.  HARTZ  COMPANY,  Manufacturers, 

103-105  Miami  Avenue,  2  Richmond  Street,  E., 

Detroit,  Mich.  Toronto,  Ontario. 


VI 


DETROIT    MEDICAL    JOURNAL 


When  you  are  about  to  complete 
your  office  equipment  by  adding  a 
surgical  chair  write  us  or  see  our 
goods  at  your  dealers.  We  are  pre- 
pared to  give  you  better  value  in 
chairs  than  any  other  manufacturer 
can  give,  and  the  dealer  selling  our 
goods  will  make  you  the  same 
proposition  that  we  do.  We  will 
sell  you  an  improved  Yale  chair 
complete  for  $65.00  in  payments,  or 


for  $60.00  cash ;  a  Cornell  chair  for  $60.00  in  payments,  or  for  $54.00  cash ; 
oran  Oxford  chair  for  $50.00  in  payments  or  for  $45.00  cash.  Our  chairs 
have  been  recognized  as  the  standard  for  twenty  years,  and  are  sold  in  every 
state   in  the  Union. 

THE  CANTON  SURGICAL  AND  DENTAL  CHAIR  CO. 


Exclusive  Manufacturers 


CANTON,  OHIO 


TO-KALON  WINES 

Strictly  pure  and  guaranteed  to  conform  with  the  Pure  Food 
laws  of  any  state. 

The  attention  of  physicians  is  directed  to  our 

REGENT  CHAMPAGNE 


which  is  recommended  for  medical  use,  as  being  fully  equal  to  any 
imported  Champagne,  and  costing  about  one-half  as  much. 

Out  entire  list  of  Wines  and  Brandies,  more  particularly  the 
REGENT  CHAMPAGNE,  may  be  had  from  the  J.  F.  HARTZ 
CO.,  Detroit,  Mich. 


To-Kalon  Vineyard  Co. 


CALIFORNIA 


CHICAGO 


DETROIT   MEDICAL   JOURNAL 


VII 


Kutnow's  Powder 


For  LIVER  and  KIDNEY  DERANGEMENTS 


THERAPEUTIC  NOTES. 

Kutnow's  Powder  Is  an  ideal  Antiseptic  Aperient  before  and  after 
operations.    As  a  post-surgical  cathartic  nothing  in  the  materia  medica 
could  easily  replace  it  in  order  to   overcome   nausea   caused   by  the 
anaesthesia,  to  stop  the  vomiting,  and  at  the  same  time  to  coax  the 
peristalsis.    Its  therapeutic  value  has  been  thoroughly  tested  by  many 
celebrated  surgeons  who  have  commended   it  in  the  highest     terms. 
Kutnow's  Powder  is  portable,  economical,    palatable   and    always   re- 
liable.    It  is   readily  taken   by  women  and  children,  and,  containing 
no  sugar,  it  is  successfully  prescribed  in  diabetes  and  for  patients  with 
a  uric-acid  diathesis.     "Its  advantages,"  says  a  medical  correspond- 
ent, "appear  to  arise  from  its  possessing  the  power  to  eliminate  from 
the  body  the  excess  of  bile  and   acids,   thereby   purifying   the     blood 
and  strengthening  the  general  tone   by   improving     the     assimilative 
processes  of  the  debilitated  system.     Consequently  it  has  a  salutary 
effect  in  cases  of  hypochondriasi  s  associated  with  low  spirits  and  gen- 
eral depression." 


SAMPLES  SENT  FREE  TO  PHYSICIANS 


SIGN  THIS  FORM. 

To  obtain  Kutnow's  Powder  Free  of  Charge 


Name 


Address- 


Detroit  Medical  Journal. 

Send  this  form  to  Kutnow  Bros.,  Ltd. 
853  Broadway.  New  York  City. 


KIJTNOW  BROS.,  Ltd.,  853  Broadway,  New  York  City, 

And  at  41  rarringdon  Rd.,  London,  E.  C,  England 


VIII 


DETROIT    MEDICAL    JOURNAL. 


GLOBE    NEBULIZERS 

Special  Offer  ^^^ 


3^3^3CSS®X®35®3{®3{®X®%®%J 


For  a  short  time  we  can  make  you  a  special  offer 
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35  Grant  St.  Battle  Creek,  Mich.  U.  S.  A. 


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and  others,  choice  of    more    routes    at 
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For  further  information,  write  or  call 

Wabash  City  Ticket  Office, 

9  Fort  Street,  DETROIT 


A.   F.   Wolfschlager,  Pass.  &  TIct.  Agt. 


Automatic  Cap. 
No  Effort.    No  loss  of  Time. 


KELENE 


(Pure  Chloride  of  Ethyl) 

Send  $1.10  for  large  30  grain  sample  Automatic 
Tube  ;  or  for  $1.00  a  Double  ended  Tube  will  be  sent 
postpaid  in  the  U.  S.    Safe  delivery  Guaranteed. 

Write  for  literature  on  Formaldehyde-Kelenefor  use 
in  Hay  Fever,  Catarrh,  etc. 

We  also  furnish  a  Graduated  Tube  for  the  use  of 
KELENE  in  GENERAL  ANAESTHESIA,  also  as  a 
preliminary  to  Ether.  Each  tube  contains  50  C.  C.,  and 
costs  $1.60.    Safe  delivery  guaranteed. 

Read  Dr.  Martin  W.  Ware's  article  in  the  Journal  of 
the  American  Medical  Association,  Nov.  8,  1902  issue, 
on  page  1 160,  concerning  his  experience  in  over  1,000 
cases.    Copies  sent  upon  request. 

Write  to  the  sole  manufacturers  for  full  particulars, 
Clinical  Reports,  etc. 

FRIES  BROS., 

Manufacturing 
Chemists 

93  Reade  Street,  NEW  YORK 


DETROIT    MEPICAL    JOURNAL  I> 


IT    RELIEVES  IT    STIMULATES 

CONGESTION  THE  CIRCILATION 

FOR 

ENTERO-COLITIS 

ESPECIALLY  IN  CHILDREN 

ISE 

ANTIPHLOGISTINE 

Spread  Antiphlogistine  over  the  entire  abdominal  wall,  at 
least  1-8  inch  thick  and  as  hot  as  can  comfortably  be  borne,  and 
cover  the  dressing  with  a  liberal  amount  of  absorbent  cotton  and 
a  suitable  conipress. 

This  will  form  a  most  satisfactory  adjunct  to  the  successful 
treatment  of  these  cases,  because  it  produces  a  depletion  of  tlie 
enteric  and  peritoneal  vessels  and  stimulates  the  various  plex- 
uses, more  particularly  the  sol^r  and  hypogastric,  relieves  the 
pain,  the  tenesmus,  the  muscular  rigidity  and  obviates  the  neces- 
sity for  the  administration  of  opiates  and  powerful  heart  stimu- 
lants. 


POISON  IVY  -  POISON  OAK  -  SINBIRN 

As  an  application  to  relieve  the  dermatitis  caused  by -con- 
tact with  poisonous  plants  as  well  as  that  caused  by  exposure 
to  the  sun,  Antiphlogistine  cannot  be  surpassed. 

Insure  obtaining  Antiphlogistine  at  its  best  by  prescribing 
original  packages,  and  designating  the  size. 

Small — Medium — Large — Hospital. 

THE  DENVER  CHEMICAL  MFG.  CO., 
New  York 


DETROIT  MEDICAL  JOURNAL 


SEE  THAT  RING? 

.  THE  ''BREAKABLE''  TUBE  THAT 
GIVES  SATISFACTION  TO  THE 
MOST  EMINENT  SURGEONS- 
STERILE  CATGUT  AND  SILK 


PRODUCT  OF  THE  LABORATORIES  OF 

I  ELLWOOD  LEE  COMPANY 

CONSHOHOCKEN,    PENNSYLVANIA 


ASK  US  FOR  BROCHURE  "STITCHES  AND  KNOTS'' 


MENTION  THIS  JOURNAL 


IN 


PILE»    ANH 


CONSTIPATION 


The  best 
results  may 
be  obtained 
by  the  use 
of  .  .  . 
YOUNG'S 
se  If -retain- 
ing   ..    . 

RECTAL  DILATOR8 

They  are  made  of  hard  rubber  and 
come  in  sets  of  fotir  sizes.  May  be 
used  by  any  intelligent  person.  Their 
use  accomplishes  for  the  invalid  just 
what  nature  does  daily  for  the  healthy 
individual.  If  you  will  prescribe  a  set  of 
of  these  dilators  in  some  of  your  obsti- 
nate cases  of  Chronic  Constipation  you 
will  find  them  necessary  in  every  case 
of  this  kind.  Price  to  the  profession, 
12.50  per  set  Sold  by  leading  instru- 
ment houses  and 


f.  E.  YOUNG  e*  CO., 

46  MIchlcMin  Avenue,  -         CHICAQO 


60    YEARS' 
EXPERIENCE 


Trade  Marks 
Designs 
Copyrights  &c. 

Anyone  sending  a  sketch  and  description  may 
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The  Detroit  Medical  Journal 

Vol.  V.  AUGUST,  1905.  No*  5* 


RECIPIENTS  OF  THE  NOBEL  PRIZE  IN  PHYSIOLOGY  AND  HEDICINE. 

• 

(At  the  sugg-estion  of  the  chairman  of  the  Section  of  Internal  Medicine  of  the  Wayne 
County  Medical  Society,  the  evening  of  May  8th,  1905,  was  devoted  by  the  Program 
Committee  to  a  consideration  of  the  achievements  of  the  recipients  of  the  Nobel  prize 
In  physiology  and  medicine.  The  program  consisted  of  an  introductory  statement  by 
the  chairman,  Dr.  Sherrill,  and  papers  by  Drs.  Kiefer,  Mann.  Varney  and  Safford.  There 
followed  a  discussion  participated  in  by  Drs.  McClintock,  Delos  Parker,  Hickey  and 
Wagner,  The  papers  contain  information  of  decided  interest  not  readily  obtained  and 
we  take  pleasure  in  giving  them  to  Detroit  Medical  Journal  readers.— Ed.) 

ALFRED   BERNARD   NOBEL. 

By  EDWIN  S.  SHERRIDL,  M.  D. 
Detroit. 


I  would  like  to  make  it  possible  for  each  one  of  you,  from  the  in- 
formation I  shall  give  to  answer  the  following  questions : 

1.  Who  was  the  founder  of  the  Nobel  prizes,  and  what  was  his  career? 

2.  What  prompted  him  to  found  the  prizes? 

3.  What  provision  did  he  make  for  the  prizes? 

4.  How  are  the  prizes  awarded? 

Alfred  Bernard  Nobel  was  born  at  Stockholm,  Sweden,  Oct.  21,  1833. 
He  was  the  third  son  of  .Emmanuel  Nobel,  who  was  a  manufacturer  of 
explosives.  At  the  age  of  17  he  was  sent  to  the  United  States  to  study 
under  the  famous  engineerjohn Ericsson  (of  Monitor  fame).  On  reaching 
his  2ist  year  he  returned  to  his  home  at  St.  Petersburg  where  his  father 
had  gone  because  of  the  objection  of  his  neighbors  to  his  noisy  and  dam- 
aging experiments  and  in  order  to  prepare  mines  and  torpedoes  for  the 
Russian  government  during  the  Crimean  war.  Nobel  is  said  to  have  be- 
come trained  as  an  engineer ;  to  speak  fluently  Swedish,  Russian,  English, 
German  and  French.  He  took  up  the  study  of  chemistry  and  became 
proficient  in  the  technical  application  of  the  science.  He  was  constantly 
engaged  with  his  father  in  pursuing  some  invention.  Among  other  sub- 
stances nitroglycerin  especially  occupied  their  attention.  Some  time  after 
the  close  of  the  Crimean  war,  the  family  returned  to  Stockholm  and  in 
1862  the  father  and  sons  had  erected  a  plant  at  Helenborg  where  nitro- 
glycerin was  manufactured  on  a  commercial  scale  for  the  first  time.  In 
1864  these  works  were  destroyed  by  an  explosion  which  killed  several 
persons,  including  the  younger  brother,  Oscar  Nobel.  The  calamity  so 
affected  Nobel's  father  that  he  became  paralytic.  Alfred  Nobel  imme- 
diately erected  new  works  on  a  barge  in  Lake  Malaren,  and  in  1865  en- 
listed capital  for  works  on  a  large  scale  in  Sweden  and  Germany.  So 
many  accidents  occurred  with  nitroglycerin  that  the  transportation  of  it 
was  interdicted.  Now  came  the  discovery  of  dynamite.  It  was  in  Ham- 
burg, where  he  had  set  up  a  small  factory  that  some  powder  trickled  out 

Detroit,    Mich.,   Aug.   15,   1905.  VOL.  5,   NO.  5. 


146  DETROIT     MEDICAL    JOURNAL 

of  one  of  his  nitroglycerin  casks  upon  the  damp  earth  and  became 
spoiled.  However,  when  the  moisture  had  evaporated  Nobel  found  that 
one  part  of  this  earth  mixed  with  three  parts  of  nitroglycerin  not  only 
increased  its  explosive  powder,  but  rendered  it  comparatively  safe  for 
handling.  With  this  discovery  in  the  latter  part  of  1866,  began  his 
enormous  success.  Before  long  he  was  directly  at  the  head  of  three  fac- 
tories in  America,  three  in  France,  and  one  in  Sweden.  In  1871,  at  Ar- 
deer,  Scotland,  he  erected  the  works  which  are  now  the  largest  dynamite 
works  in  the  world. 

Incidentally  it  may  be  suggested  that  there  is  very  good  reason  for 
the  recognition  of  American  genius  in  the  awarding  of  prizes  since  we 
have  contributed  largely  to  the  Nobel  fortune.  In  1900,  42,923  tons  of 
dynamite  were  manufactured  in  this  country  alone,  representing  a  valua- 
tion of  not  less  than  $8,000,000. 

In  1875  Nobel  invented  explosive  gelatine  and  the  gelatine  dyna- 
mites. In  1880  he  invented  ballistite.  He  was  interested  in  many  other 
arts  than  that  of  explosives,  having  taken  out  in  England  alone  129 
patents.  In  1878,  with  his  brothers  Ludwig  and  Robert,  he  formed  the 
famous  firm  of  Nobel  Brothers  that  operated  the  petroleum  wells  at 
Baku,  Russia,  and  has  proved  the  most  active  competitor  of  the  Standard 
Oil  Co.  He  purchased  the  large  ordinance  works  at  Bofors,  Sweden,  that 
he  might  the  more  readily  carry  out  his  inventions  in  ordinance  and  his 
investigations  in  metallurgy. 

When  he  had  attained  great  fortune  he  went  to  Paris  with  the  idea 
of  having  a  sort  of  salon.  Bridgman  says  he  himself  was  a  person  to  have 
graced  such  an  institution.  His  manners  were  of  the  most  distinguished 
courtesy,  his  mind  original  and  his  experiences  interesting.  In  spite  of 
his  genius  for  physical  science  he  was  by  no  means  a  one-sided  man.  He 
devoted  himself  largely  to  what  he  called  ideal  literature,  of  which  poetry 
formed  the  greater  part.    Stead  refers  to  him  as  the  "pious  founder." 

Nobel  learned  the  estimate  put  upon  him  by  the  French  at  the  time  his 
brother  Robert  died.  Many  French  journalists  thought  Alfred  Nobel 
had  passed  away  and  wrote  his  obituary  notices  on  that  assumption.  He 
then  left  Paris  and  went  to  San  Remo  where  he  built  a  beautiful  home  in 
which  he  died  December  loth,  1896.  (Munroe). 

Nobel  left  a  fortune  of  over  nine  million  of  dollars,  and  in  his  will, 
after  leaving  small  legacies  to  his  already  wealthy  relatives,  directed  that 
•  the  residue  should  constitute  a  fund,  the  interest  from  which  should  be 
divided  into  five  equal  amounts  and  awarded  as  prizes.  Each  prize 
amounts  to  about  $40,000.  The  will  was  contested  by  heirs  but  a  com- 
promise was  effected  on  condition  that  a  portion  of  the  property  be  de- 
voted to  the  founding  of  institutions  for  research  known  as  Nobel  In- 
stitutes, which  has  been  done. 

Nobel  makes  a  memorable  statement  explaining  why  he  left  his 
wealth  to  public  purposes.  "Experience  has  taught  me,"  he  said,  "that 
great  fortunes  acquired  by  inheritance  never  bring  happiness ;  they  tend 
to  dull  one's  powers.  Any  man  possessing  a  large  fortune  ought  not  to 
leave  more  than  a  small  part  of  it  to  his  heirs,  not  even  to  his  direct  heirs 


SHERRILL:     RECIPIENTS    OF   NOBEL   PRIZE  147 

— just  enough  to  enable  them  to  make  their  way  in  the  world.  It  is  in- 
justice to  leave  them  a  great  sum  of  money  which  they  themselves  have 
not  deserved,  which  favors  idleness  and  prevents  the  matural  develop- 
ment of  the  faculty  of  personal  initiation  which  is  in  us — the  tendency 
to  create  an  independent  position  for  oneself." 

In  the  following  terms  he  indicated  to  his  executors  his  wishes  with 
reference  to  the  prizes,  (i)  One  to  go  to  the  man  who  shall  have  made 
the  most  important  discovery  or  invention  in  the  domain  of  psysical 
science ;  (2)  Another  to  go  to  the  man  who  shall  have  made  the  most  im- 
portant discovery  or  introduced  the  greatest  improvement  in  chemistry; 
(3)  the  third  to  the  author  of  the  most  important  discovery  in  the  domain 
of  physiology  or  medicine ;  (4)  the  fourth  to  the  man  who  shall  have  pro- 
duced the  most  remarkable  literary  work  of  an  idealistic  nature;  (5)  and 
finally  the  fifth  to  the  person  who  has  done  most  or  labored  best  for  the 
cause  of  fraternity  among  different  peoples,  for  the  suppression  or  re- 
duction of  standing  armies,  or  for  the  promotion  of  peace  congresses." 

Four  of  the  prizes  are  passed  upon  at  Stockholm,  the  first  four  men- 
tioned above,  but,  the  peace  prize  is  passed  upon  at  Christiana,  Norway. 

In  awarding  prizes  there  is  the  work  of  nominators  and  the  work  of 
judges.  For  the  four  prizes  awarded  at  Stockholm  nominations  of  can- 
didates may  be  made  by 

(a)  The  Swedish  Academy. 

(b)  Members  resident  or  foreign  of  the  Royal  Academy  of  Sciences 

of  Sweden. 

(c)  Members  of  the  Swedish  Nobel  committees. 

(d)  Professors  in  the  various  universities  of  Norway  and  Sweden. 

(e)  Professors  in  foreign  universities  who  may  be  named  therefor 

by  the  Swedish  Academy. 

(f)  Distinguished  men  to  whom  the  Academy  may  think  good  to 

send  an  invitation  to  suggest  a  nomination.    The  nomina- 
tions with  the  writings  of  the  persons  nominated  must  be 
delivered  to  the  Swedish  Academy  by  Feb.  ist. 
For  the  peace  prize  awarded  at  Christiana  the  nominators  of  can- 
didates are : 

(i)     Members  of  the  Norwegian  Nobel  committee. 

(2)  Members  of  the  legislative  assemblies  and  governments  of  the 

various  states  of  the  world. 

(3)  Members  of  the  Commission  of  the  Permanent  International 

Buread  of  Peace. 

(4)  Members    and    associates    of    the    International    Institute    of 

Lavv^,  and 

(5)  University  professors  of  law,  of  political  science,  of  history  and 

philosophy. 

Proposals  for  this  prize  must  be  sent  to  the  Norwegian  Nobel  com- 
mittee, Christiana,  not  later  than  April  ist. 

In  physics  and  chemistry  the  selecting  body  is  a  pair  of  Nobel  com- 
mittees of  four  persons  named  by  the  Swedish  Academy  of  Sciences.  In 
medicine  the  arrangement  is  similar,  the  Royal  Caroline   Institute,   of 


148  DETROIT     MEDICAL    JOURNAL 

Stockholm,  being  the  leading  body  in  the  choice  of  a  Nobel  committee  in 
medicine.  In  literature  the  procedure  is  analagous,  the  Swedish  Acade- 
my taking  the  lead,  but  with  the  co-operation  of  the  French  Academy 
and  other  literary  academies  of  Europe.  The  Norwegian  Storthung  or 
Parliament  nominates  the  committee  of  five  which  adjudicates  the  peace 
prize. 

The  awards  are  announced  at  Stockholm  at  7  p.  m.,  Dec.  loth,  of 
each  year,  the  anniversary  of  Nobel's  death.  It  is  expected  that  the  prize 
winner,  within  six  months,  will  lecture  upon  the  subject  for  which  the 
prize  was  awarded  at  Stockholm  or,  in  the  case  of  the  peace  prize,  at 
Christiana. 

It  is  not  necessary  here  to  give  the  recipients  of  the  prizes  other  than 
in  medicine.  The  four  awards  have  been  made  in  the  order  given  on  our 
society  program. 

1901 — Emil  A.  Behring. 

1902 — Ronald  Ross. 

1903 — Neils  R.  Finsen> 

1904 — ^John  P.  Pawlow. 

With  this  introduction  I  trust  there  will  be  increased  interest  in  the 
papers  of  the  evening.  Permit  me  to  suggest  that  somehow  it  should  be 
made  possible  for  American  talent  to  be  brought  more  satisfactorily  to 
the  notice  of  the  judges  of  these  prizes. 


EMIL  ADOLPH  BEHRINQ. 

By  GUY  L.  KIE'FER.  M.  D. 
Detroit. 


Emil  Adolph  Behring  was  born  in  1854,  at  Hansdorf,  in  Prussia.  He 
is  the  son  of  a  teacher  in  Haaswalde,  near  Eglau.  He  stduied  medicine 
at  Berlin,  and  in  1880  became  an  army  surgeon.  In  1894  he  was  ap- 
pointed to  a  professorship  at  the  University  of  Halle  and  in  the  following 
year  was  called  to  be  director  of  the  Hygienic  Institute  at  Marburg. 

Behring  is  credited  with  being  the  discoverer  of  diphtheria  antitoxin, 
and  attained  a  great  reputation  bythat  achievement  and  by  his  contribu- 
tions to  the  subject  of  immunity. 

Ferran,  of  Barcelona,  Spain,  (Boston  Medical  and  Surgical  Journal, 
January  24,  1895,  page  94),  claimed  to  have  been  the  discoverer  of  a  prac- 
tical and  safe  method  of  immunizing  animals  against  fatal  doses  of  diph- 
theria toxin.  His  claim  was  adjudged  just  by  Karl  Fraenkel.  Prof.  V. 
Babes,  of  Buda-Pesth,  who  also  claimed  to  have  made  the  discovery,  in- 
asmuch as  he  had  established  the  same  principle  concerning  hydrophobia 
in  1889,  admits  that  to  Behring  belongs  the  credit  of  applying  the  prin- 
ciple to  diphtheria. 

Efforts  to  attain  immunity  have  been  made  by  many  investigators 
during  a  long  period  of  years,  dating  back  to  the  time  of  Jenner  and  the 
first  successful  vaccination.  The  discovery  of  serums  containing  anti- 
toxin is  but  a  natural  consequence  of  the  older  discoveries.  Loeffler  cul- 
tivated the  bacillus  that  bears  his  name  in  1883.     He  was  followed  by 


KIEFER:       EMIL    ADOLPH    BEHRING  149 

Roux  and  Yersin  whose  classic  monograph  threw  a  flood  of  light  upon 
the  subject. 

In  1890,  Behring  and  Kitasato  demonstrated  the  presence  of  anti- 
toxic proteids  in  the  blood  and  serum  of  rabbits  vaccinated  against  tetan- 
us. They  found  that  this  serum  had  the  power  of  destroying,  during  life, 
the  toxin  of  tetanus.  This,  the  first  communication  of  Doctors  Behring 
and  Kitasato  on  the  immunizing  power  of  the  blood  serum  of  artificially 
immunized  animals,  was  published  in  the  Deutsche  Medizinische 
Wochenschrift,  No.  49,  1890. 

In  1891,  Brieger  and  Fraenkel  began  the  special  study  of  the  toxin. 
Wasserman  and  Proskauer  apparently  isolated  it  in  1892,  but  his  investi- 
gations on  diphtheria  in  1891,  and  this  was  the  real  beginning  of  the  so- 
called  "system  of  blood  serum  therapeutics."  Ernst,  of  Boston,  says 
(Boston  Medical  and  Surgical  Journal,  September  5,  1895),  "his  enthu- 
siastic work,  together  with  that  of  Wernicke,  Aronson,  Ehrlich,  Kossel, 
Wasserman  and  Roux,  have  led  us  through  the  slow  and  dangerous  im- 
munizing of  the  lower  animals,  by  means  of  the  cultures  and  toxins  of 
the  bacillus  of  diphtheria,  to  the  rapid  and  safe  immunity  following  the 
use  of  the  antitoxin  contained  in  the  serum  of  immune  animals." 

In  1893  the  Koch  Institute  for  Infectious  Diseases  issued  a  report  on 
the  diphtheria  serum  of  Behring  favorable  to  the  conclusion  that  in  it  we 
possessed  a  specific  for  that  disease.  This  serum  was  derived  from  diph- 
theria-immune sheep,  and  was  under  government  control  for  a  time.  In 
1894,  the  well  known  newspaper,  the  Figaro,  inquired  of  Prof.  Behring 
what  part  Loeffler,  Roux  and  Behring  had  taken  in  the  discovery  of  the 
curative  serum.    Behring  replied,  in  a  letter  dated  at  Halle,  October  26th: 

"Prof.  Loeffler  is  the  discoverer  of  the  diphtheria  bacillus,  and  he 
was  the  first  to  publish  correct  views  respecting  the  nature  of  the  diph- 
theritic poison.  Dr.  Roux  was  the  first  to  stuly  the  diphtheritic  poison 
with  greater  precision.  Without  the  discovery  of  the  diphtheria  bacillus 
and  of  the  diphtheritic  poison  the  diphtheria  curative  serum  would  not 
have  been  invented.  To  this  extent  Loeffler  and  Roux  have  performed  a 
material  part  in  the  elaboration  of  the  new  agent."  Neither  Loeffler  nor 
Roux  has  ever  claimed  any  share  of  the  credit  for  discovering  the  cura- 
tive serum.  The  latter  has  been  successful  in  producing  the  curative 
serum  after  acquiring  familiarity  with  the  German  reports. 

Behring's  discovery  in  thus  described  by  W.  F.  Robie  (Boston  Med- 
ical and  Surgical  Journal,  September  5,  1895,  page  240)  :  "While  I  was  in 
the  medical  school  I  learned  that  he  had  isolated  two  albumenoid  sub- 
stances from  cultures  of  the  Klebs-Loeffler  bacillus ;  and  that  he  had 
found  that  ordinary  cultures  of  the  diphtheria  bacillus  heated  to  60  or 
70  degrees  Fahrenheit  and  then  injected  beneath  the  skin  of  animals  had 
the  power  of  conferring  immunity;  and  that  he  had  also  found  that  the 
addition  of  iodine  trichloride  to  old  cultures  of  the  bacillus  also  gave  im- 
munity when  they  were  injected  subcutaneously. 

"If  he  had  stopped  here,  we  should  have  had  for  diphtheria  a  remedy 
analagous  to  tuberculin  for  tuberculosis ;  but  he  went  one  step  further. 
He  injected  subcutaneously  the  poison  or  toxin,  made  from  cultures  of 


150  DETROIT     MEDICAL     JOURNAL 

diphtheria  bacilli,  into  various  animals.  Large  quantities  at  first  would 
kill  the  animals,  but  small  quantities  repeated  from  time  to  time  would 
be  borne,  and  after  a  time  the  animal  became  accustomed  to  the  poison 
and  larger  doses  could  be  used.  This  was  kept  up  for  months.  Then  the 
blood  was  taken  and  the  serum  was  injected  into  animals  suffering  in 
varying  degrees  from  the  diphtheritic  poison  or  into  animals  exposed  to 
the  poison.  He  found  that  animals  which  had  received  injections  of  this 
blood  serum  in  sufficient  quantities  would  not  develop  diphtheria,  under 
any  circumstances^  for  some  time  after  the  injections.  This  immunity 
would  always  be  temporary,  but  would  last  from  several  days  to  several 
weeks,  according  to  the  amount  of  serum  injected." 

In  1897  Behring  announcel  that  he  had  improved  his  serum  (Fort- 
schritte  der  Medicin)  so  that  ill  effects  would  be  avoided.  The  strength 
of  the  serum  reckoned  in  antitoxic  units  was  increased,  so  that  only  a 
small  quantity  of  serum  was  now  needed  to  produce  immunity.  The 
effect  was  to  reduce  the  complications,  such  as  urticaria,  joint  pains  and 
other  ill  effects  of  the  injection  of  horse  serum. 

In  1894  an  application  was  made  for  a  patent  in  England  for  anti- 
toxin, by  a  Frenchman,  according  to  the  British  Medical  Journal, 
December  22,  1894.  A  patent  for  diphtheria  antitoxin  was  granted  to 
Behring,  in  this  country,  in  1898.  In  1894,  British  makers  began  to  sup- 
ply diphtheria  antitoxin.  About  this  time  Behring  and  Virchow  en- 
gaged in  a  controversy,  evidently  the  outcome  of  mutual  misunderstand- 
ings, in  which  Virchow  explained  that  he  had  used  Aronson's  (Scher- 
ing's)  serum,  but  had  had  no  experience  with  Behring's.  He  recom- 
mended that  a  comparative  test  of  the  two  serums  be  made. 

The  Nobel  Prize  in  Medicine  was  awarded  to  Prof.  Behring,  of  Mar- 
burg, in  December,  1901.  The  amount  was  208,000  francs.  The  patent 
of  nobility  was  also  conferred  upon  him  the  same  year  by  the  German 
emperor.  {To  be  Continuea) 


ETIOLOQY  OF  DIABETES.* 

By  SPENCER  C.  DICKERSON,  B.  S.,  M.  D. 
New  Bedford,  Mass. 


To  the  physiologist  carbohydrate  metabolism  has  always  offered  a 
most  interesting  field  for  observation  and  experimentation;  and  the 
problems  associated  with  the  causation  of  sugar  assimilation  by  the  tis- 
sues has  given  a  wide  opportunity  for  speculation  and  theoretical  deduc- 
tions. But  to  the  clinician  and  pathologist  the  most  interesting  phase  of 
carbohydrate  metabolism  is  associated  with  the  inability  of  the  tissues 
to  utilize  all  the  sugar  brought  to  them,  producing  as  you  know  glyco- 
suria and  diabetes.  The  purpose  of  this  paper  is  to  point  out  some  of  the 
causes  underlying  morbid  carbohydrate  metabolism. 

There  are  certain  causes  which  can  be  referred  to  briefly  as  pre- 
disposing, for  example,  age,  sex,  race,  social  conditions  and  heredity.  It 
is  a  well  known  fact  that  diabetes  occurs  more  frequently  after  the  fifth 

♦Read  before  the  New  Bedford  Medical   Society,    June   27,   1904. 


DICKERSON:      ETIOLOGY   OF   DIABETES  151 

decade,  and  that  it  is  more  rare  in  children,  but  when  it  does  occur,  the 
diabetes  is  of  a  very  malignant  type.  Clinicians  have  generally  observed 
that  glycosuria  occurs  more  frequently  in  males  than  females,  the  pro- 
portion being  three  to  two.  In  the  Negro,  however,  there  is  an  excep- 
tion, the  females  are  more  frequently  affected  than  the  males.  In  my 
six  cases,  five  were  females  and  only  one  male. 

The  disease  affects  the  upper  stratum  of  humanity  more  than  the 
lower  stratum.  According  to  the  statistics  of  Von  Noorden  for  Lon- 
don and  Berlin  the  number  of  cases  in  the  upper  ten  thousand  exceed 
exceeds  that  in  the  lower  hundred  thousand  inhabitants.  The  Hebrew 
race  very  frequently  suffer  with  diabetes.  One-fourth  of  Frerich's  cases 
w^ere  Jews.  While  on  the  other  hand,  it  is  very  rare  in  the  Negro  race. 
Heredity  is  given  as  a  causative  factor  in  so  many  of  the  constitutional 
diseases,  it  is  not  surprising  that  it  is  supposed  to  play  a  very  important 
role  in  diabetes.  Gout,  tuberculosis  and  other  diathetic  disorders  are 
mentioned  as  contributory  factors  in  heredity. 

The  French  claim  that  ten  per  cent,  of  diabetics  have  family  history 
of  these  diseases.  Seeger,  14  per  cent.,  Bouchard,  25  per  cent.  Schmitz 
reports  600  cases  with  history  of  heredity  in  248;  Sir  William  Roberts 
reports  a  family  of  eight  children  all  diabetic.  In  my  six  cases  no  history 
of  diabetes,  so  far  as  the  patients  knew,  occurred  in  tl)e  family.  Several 
had  a  neurotic  family  history,  and  tuberculosis  was  in  the  family  history  of 
two  of  my  cases. 

Claude  Bernard  demonstrated  first  that  glycosuria  could  be  pro- 
duced by  a  puncture  in  the  floor  of  the  fourth  ventricle.  Bernard's  dia- 
betic centre  is  either  very  close  to  or  identical  with  the  vaso-motor  centre, 
and  the  production  of  sugar  in  the  urine  is  supposed  to  be  caused  by  the 
transforming  of  the  glycogen  in  the  liver,  as  sugar  fails  to  appear  if  the 
liver  is  devoid  of  glycogen.  Many  theories  are  advanced  to  show  how 
the  stimulation  of  the  diabetic  centre  produces  glycosuria.  First,  by  a 
disturbance  of  the  circulation  in  the  hepatic  artery,  causing  a  disturb- 
ance in  the  liver  metabolism.  Second,  by  direct  influence  of  the  nerves 
on  the  hepatic  cells.  Third,  by  stimulation  of  the  vaso-motor  centre, 
since  other  stimulation  of  the  vaso-motors,  the  sciatic,  central  end  of 
^/agus,  the  depressor  nerves,  produce  glycosuria.  It  is  claimed  that  the 
glycemia  results  from  the  diminution  in  the  oxygen  of  the  blood  in  the 
hepatic  artery  causing  a  stimulation  of  the  liver  cells. 

By  the  administration  of  phloridzin  sugar  appears  in  the  urine.  This 
is  accounted  for  on  the  grounds  that  phloridzin  causes  an  increased  per- 
meability to  sugar  of  the  renal  epithelium.  Still  recent  investigations  do 
not  confirm  this  view.  On  the  contrary  they  indicate  that  diabetes  from 
the  administration  of  phloridzin  is  the  result  of  an  exaggerated  catabolic 
condition  of  the  kidneys.  Levene  and  Stockey,  investigating  the  action  of 
phloridzin  in  Bright's  disease,  found  that  glycosuria  was  either  absent 
or  very  much  diminished  by  the  administration  of  phloridzin  in  animals 
in  which  the  kidneys  were  injured.  They  also  found  in  acute  parenchy- 
matous nephritis  that  sugar  failed  to  appear  in  the  urine  after  the  ad- 
ministration of  phloridzin. 


152  DETROIT     MEDICAL    JOURNAL 

O.  Loewi,  in  studying  the  functions  of  the  kidneys,  has  thrown  con- 
siderable light  on  renal  diabetes.  He  claims  that  crystaloid  substances 
in  free  solution  are  rapidly  excreted  by  the  kidneys,  but  they  do  not  ex- 
crete crystaloids  which  come  to  them  in  colloidal  combination.  He  con- 
tends that  the  sugar  on  entering  the  blood  under-goes  colloidal  combina- 
tion, and  hence  in  this  form  cannot  pass  the  kidneys,  but  if  an  excessive 
amount  of  sugar  enters  the  blood,  the  combining  substances  cannot  be 
provided  for  in  sufficient  amount,  therefore,  a  certain  proportion  of  the 
sugar  is  in  free  solution  and  is  therefore  quickly  excreted  by  the  kidneys. 

On  this  theory,  diabetes  after  pancreas  extirpation,  and  other  forms 
of  glycosuria,  except  phloridzin  diabetes,  are  the  result  of  a  hyper-gly- 
cemia.  In  phloridzin  diabetes,  the  kidneys  have  the  power  of  breaking 
up  this  colloidal  combination  producing,  as  it  were,  renal  diabetes. 

Certain  toxic  conditions  may  be  accomplished  with  glycosuria,  as  for 
example,  poisoning  by  acids,  mercury,  uranium,  and  thyroidin.  Moreover, 
the  injection  of  a  large  quantity  of  normal  salt  solution,  or  the  production 
r.f  diuresis  by  the  administration  of  caffeine  is  frequently  associated  with 
appearance  of  sugar  in  the  urine.  Ott  and  Harris,  by  the  subcutaneous 
injection  of  gr  xv  of  iodothyrin  in  rabbits  for  thirty  days  produced  gly- 
cosuria in  some. 

Tumors  of  the  medulla,  lesions  of  the  cord,  and  other  nervous  con- 
ditions are  sometimes  associated  with  diabetes.  Osier  claims  that  it  is 
due  to  vaso-motor  paralysis,  and  on  this  view  diabetes  would  be  a 
neurosis.  Osier  cites  a  case  in  which  a  woman  had  anomalous  cerebral 
symptoms  and  diabetes.  At  autopsy  a  cystercercus  was  in  the  floor  of 
the  fourth  ventricle.  Transient  glycosuria  may  be  associated  with  apo- 
plexy, paretic  dementia,  shock,  epilepsy,  and  injuries  to  the  head  and 
spine. 

Many  observers  have  noticed  the  co-existence  of  diabetes  and  dis- 
eases of  the  liver,  particularly  hepatic  cirrhosis.  In  280  cases  of  diabetes, 
29  were  associated  with  cirrhosis  of  the  liver.  Opie  reports  two  cases 
of  diabetes  with  atrophic  cirrhosis,  which  at  autopsy  showed  an  inter- 
stitial pancreatitis  of  the  interacinar  type.  In  eleven  of  the  twelve  cases 
of  hepatic  cirrhosis  reported  by  Steinhaus,  associated  interstitial  pan- 
creatitis was  present.  Some  observers  have  attributed  the  diabetes  co- 
existing with  hepatic  cirrhosis  to  an  anastamosis  of  the  portal  with  the 
general  circulation  permitting  the  sugar  to  pass  directly  into  the  general 
circulation.  But  according  to  the  pathological  investigations  of  Fitz, 
Opie,  Meinkowski  and  others,  it  has  been  demonstrated  that  in  most  of 
the  cases  in  which  diabetes  co-exists  with  hepatic  cirrhosis,  an  interstitial 
pancreatitis  is  present. 

Just  in  what  way  the  ductless  glands  influence  carbohydrate  assim- 
ilation is  not  yet  known.  If  the  thyroid  gland  of  animals  be  removed,  and 
the  animals  are  exposed  to  a  low  temperature,  besides  cardiac  palpita- 
tion, giddiness  and  an  increase  in  the  pulse  rate,  glycosuria  occurs. 
Beltmann  has  produced  alimentary  glycosuria  by  thyroid  feeding.  Two 
cases  of  myxedema  complicated  with  diabetes  in  children  reported  by 
Alfred  Gordon,  show  a  close  connection  of  sugar  metabolism  to  disease 


DICKBRSON:      ETIOLOGY    OF   DIABETES  153 

of  the  thyroid.  On  the  administration  of  thyroid  extract  in  these  cases 
not  only  myxedema  disappeared,  but  the  diabetes  cleared  up,  and  that, 
too,  before  the  disappearance  of  all  the  symptoms  of  myxedema.  Gordon 
claims  a  perfect  cure  of  both  conditions. 

Blum  found,  that  the  suprarenals  contain  a  substance  capable  of  pro- 
ducing glycosuria.  In  animals  on  a  diet  free  from  carbohydrates  and  al- 
lowing sufficient  time  to  elapse  for  the  glycogen  to  disappear  from  the 
Jiver,  he  produced  glycosuria  by  the  administration  of  suprarenal.  The 
experiments  of  Dr.  Herter  throws  considerable  light  on  the  relationship 
of  the  adrenals'  to  sugar  assimilation.  He  caused  temporary  glycosuria 
in  dogs  which  lasted  several  days, by  painting  the  pancreas  with  adrenalin 
chloride.  When  oxidized  the  adrenalin  chloride  was  no  longer  capable 
of  producing  the  same  action.  He  demonstrated  that  a  number  of  other 
substances  which  in  general  may  be  termed  reducing  agents  when  ap- 
plied to  the  surface  of  the  pancreas  produced  glycosuria.  Therefore  it  is 
barely  possible  that  the  adrenals  secrete  a  substance  which  in  excess  may 
neutralize  the  oxidizing  power  of  the  pancreatic  enzyme,  which  enables 
the  tissues  to  utilize  the  sugar. 

Thomas  Cawley,  as  early  as  1788,  observed  in  his  clinical  work  the 
intimate  association  of  diabetes  mellitus  to  grave  disease  of  the  pan- 
creas. Not  until  the  brilliant  experiments  of  Menkowski  and  Von 
Mehring,  in  1889,  by  extirpating  the  pancreas  in  dogs  was  the  true  rela- 
tionship of  the  pancreas  to  carbohydrate  metabolism  shown.  By  the  ex- 
tirpation of  the  pancreas  in  dogs  they  were  able  to  produce  glycosuria  in 
all  respects  comparable  to  natural  diabetes  in  man.  The  further  observa- 
tion was  made,  that  if  a  part  of  the  pancreas  remain,  or  if  the  pancreas 
from  another  dog  was  transplanted,  diabetes  failed  to  occur.  The  sub- 
sequent clinical  observations  and  pathological  investigations  confirm  the 
experiments  of  Menkowski  in  shoAving  the  close  relation  of  the  pancreas 
to  sugar  assimilation.  In  view  of  these  discoveries,  the  natural  course 
v/as  to  find  out  what  elements  of  the  pancreas  were  absent  or  affected  in 
diseases  of  pancreas  associated  with  morbid  carbohydrate  metabolism 
and  to  determine  in  just  what  way  the  pancreatic  elements  affected  the 
tissue  metabolism  of  the  sugar.  In  diseases  of  the  pancreas  in  which 
diabetes  occurs,  Fitz  has  shown  that  in  common  with  the  interstitial  in- 
flamation  there  exists  a  corresponding  destruction  of  the  parenchyma  of 
the  gland.  Opie  and  others  have  almost  conclusively  proved  that  the 
part  of  the  gland  involved  in  the  islands  of  Langerhans.  These  are 
small  round  bodies  with  no  communication  with  the  pancreatic  ducts, 
but  they  are  in  intimate  contact  with  the  capillaries,  therefore,  they  are 
accredited  with  an  internal  secretion  the  nature  of  an  enzyme,  which 
passes  into  the  blood  enabling  the  tissues  to  assimilate  the  sugars. 

Opie  has  investigated  the  elements  of  the  pancreas  chiefly  affected  in 
diabetes,  and  finds  that  in  the  interacinar  type  of  pancreatitis,  the  islands 
of  Langerhans  mainly  suffer,  whereas  in  the  inter-lobular  form  of  pan- 
creatitis these  bodies  are  spared,  and  that  diabetes  seldom  occurs.  In 
seven  out  of  nine  cases  of  the  interacinar  pancreatitis  diabetes  was  pres- 


154    "  DETROIT     MEDICAL     JOURNAL 

cnt,  and  only  one  case  of  diabetes  occurred  in  twenty  cases  of  the  inter- 
lobular type. 

Sugar  metabolism  is  so  complex,  and  the  variety  of  factors  influ- 
encing it  is  so  varied  that  it  is  not  surprising  that  many  theories  have 
been  advanced  to  explain  how  the  tissues  are  unable  to  assimilate  all  of 
the  sugar  brought  to  them. 

Lepine  regards  diabetes,  especially  pancreatic,  as  the  result  of  de- 
ficient glycolysis.  Moreover,  he  maintains  that  the  splitting  of  the  sugar 
takes  place  through  the  influence  of  a  glycolytic  ferment  in  the  blood, 
and  that  this  enzyme  is  furnished  to  the  blood  by  the  internal  secretion 
of  the  pancreas.  Croftan  comes  to  the  same  conclusion  concerning  the  . 
pathogenesis  of  diabetes.  He  maintains  that  deficient  glycolysis  in  dia- 
betics results  from  a  deficiency  of  the  glycolytic  ferments  of  the  blood 
which  destroys  the  sugar.  The  glycolytic  ferment  is  not  contained  in  the 
serum  but  in  the  leucocytes.  Spitzer,  Kraus  and  Minkowski,  by  making 
a  number  of  experiments  failed  to  confirm  Lepene's  conclusion.  They 
found  that  diabetic  blood  possessed  as  much  glycolytic  power  as  normal 
blood. 

Achard  and  Weil  admit  that  there  is  diminished  glycolysis  in  dia- 
betes, but  the}^  attribute  it  to  a  weakening  of  the  functions  of  the  body 
in  general,  Avhich  condition  permits  the  rapid  appearance  of  sugar  in  the 
kidneys.  Bendix  and  Bickel  while  they  agree  that  the  blood  possesses 
glycolytic  power,  assert  that  this  glycolysis  is  not  due  to  a  specific 
glycolytic  enzyme,  but  to  the  alkalescence  of  the  blood.  They  showed 
that  a  pure  soda  solution  had  the  power  of  decomposing  sugar. 

Lepine  and  Gans  state  there  is  a  decrease  in  the  alkalinity  of  the 
blood  in  diabetes,  and  that  the  therapeutic  benefit  of  the  alkalies  results 
from  the  re-establishment  of  the  normal  alkalescence  of  the  blood.  We 
had  occasion  to  mention  Loewi's  theory  in  connection  with  phloridzin 
diabetes.  You  recall  that  he  claims  that  the  sugar  on  entering  the  blood 
unites  with  some  substance  forming  a  colloidal  combination,  in  which 
form  it  cannot  be  execreted  by  the  kidneys.  If  his  explanation  be  correct 
it  seems  to  me,  that  in  all  cases  of  Bright's  disease  there  should  be  a  con- 
comitant glycosuria  since  albumen  is  a  typical  colloidal  substance. 

When  it  was  plain  that  diseases  of  pancreas  was  the  chief  causative 
factor  in  the  production  of  diabetes,  clinicians,  remembering  the  salutary 
effect  of  tyroid  extract  in  diseases  of  the  thyroid,  especially  myxedema, 
supposed  that  pancreatic  extract  would  have  a  similar  influence  in  dia- 
betes. A  number  of  trials  have  proved  the  inefliciency  of  this  therapeutic 
agent,  and  hence  there  must  be  some  other  factor  besides  that  of  the  pan- 
creatic secretion  necessary  for  carbohydrate  assimilation. 

Recently  Otte  Conheim's  experiments  have  thrown  much  light  on 
the  pathogenesis  of  diabetes.  He  claims  that  sugar  is  decomposed  in 
large  quantities  in  the  muscles  presumably  by  the  action  of  an  enzyme. 
There  is,  however,  no  ferment  of  note-worthy  action  which  can  be  ex- 
tracted from  the  muscles.  He  took  frozen  muscles  and  subjected  them 
to  a  pressure  of  300  atmos.  The  fluid  thus  produced  did  not  cause  de- 
composition of  grape  sugar.     When  he  mixed  it  with  pancreatic  fluid 


FECHHEIMER:       DIABETES    INSIPIDUS  155 

similarly  obtained,  grape  sugar  was  decomposed  rapidly.  Neither  fer- 
m.ent  possesses  any  appreciable  glycolytic  power,  but  in  combination 
they  enable  the  tissues  to  decompose  and  assimilate  sugar.  Therefore, 
the  pancreas  furnishes  the  blood  a  ferment,  which  is  acted  upon  by  a  fer- 
ment in  the  muscles,  making  them  capable  of  sugar  assimilation. 

The  preliminary  report  of  A.  C.  Croftan,  concerning  the  reduction  of 
diabetic  glycosuria  by  the  administration  of  pancreas  hemoglobin  muscle 
extract,  seems  to  be  a  therapeutic  support  of  Cohnheim's  theory.  Crof- 
lan  administered  this  extract  in  six  cases  of  diabetes  which  were  followed 
by  a  marked  reduction  in  sugar  excretion  in  twenty-four  hours. 

Now,  gentlemen,  I  have  attempted  in  this  brief  summary  of  the 
etiological  factors  of  diabetes  to  give  you  the  most  recent  and  the  most 
salient  facts  regarding  the  fundamental  basis  of  morbid  carbohydrate 
metabolism.  I  cannot  speak  with  authority  either  from  a  large  clinical 
experience,  or  from  an  extended  experimental  investigation,  still,  to  my 
mind,  the  pathogenesis  of  sugar  assimilation  is  at  the  present  time  a 
problem  whose  solution  awaits  further  experimental  investigation. 


A  CASE  OF  DIABETES  INSIPIDUS.* 

M.  A.  PECHHEIMER,  M.  D., 
Detroit.   Mich. 


Mr.  A.  S.  M.,  aged  19  years,  consulted  me  February  ist,  1905,  for 
the  relief  of  an  intense  thirst  and  continuous  passages  of  enormous 
quantities  of  urine.  This  trouble,  as  near  as  can  be  determined,  began 
about  one  year  ago.  The  onset  was  very  gradual,  with  increasing 
symptoms.  Shortly  thereafter  the  patient  would  be  compelled  to  arise 
at  night  to  urinate.  These  symptoms  increased  in  severity  until  the 
present  time,  when  the  frequency  of  micturition  is  every  one  to  two 
hours,  and  the  quantity  at  each  interval  is  one  to  two  pints.  During  the 
night  he  is  now  compelled  to  arise  from  two  to  five  times  and  voids  at 
leastone  and  one-half  pints  each  time.  During  a  course  of  fifteen  or  more 
observations,  extending  from  February  ist  to  March  i8th,  this  young 
man  passed  from  fourteen  pints,  the  lowest  to  twenty-two  pints,  the 
highest,  during  twenty-four  hours,  the  average  being  twenty  pints. 

Careful  microscopic  and  chemical  examinations  of  the  urine  re- 
vealed nothing  pathologic.  The  specific  gravity  varied  from  i.ooi  to 
T.005;  reaction  slightly  acid,  absence  of  albumen  and  sugar.  Its  appear- 
ance very  closely  resembled  water. 

In  this  young  man's  case  there  was  no  history  of  traumatism.  He 
had  diphtheria  at  the  age  of  five  or  six,  and  an  attack  of  measles  in 
December,  1903.  He  had  no  other  diseases  common  to  childhood.  The 
young  man  has  been  afflicted  with  stammering  all  his  life,  but  is  other- 
wise of  average  intelligence.  He  has  never  been  addicted  to  the  use  of 
alcohol  in  any  form.  He  has  never  had  any  venereal  disease,  and  in  fact, 
his  mode  of  life  has  been  all  that  could  be  desired.  His  mother  died  at 
the  age  of  55  or  60,  the  cause  of  which  is  unknown.  His  father,  aged 
75,  ib  living  and  well.     Two  sisters,  aged  25  and  30,  and  two  brothers. 

Read  before  the  Wayne  County  Medical  Society,  Aoril  17th,  1905. 


156  DETROIT     MEDICAL    JOURNAL 

aged  23  and  2^,  are  living  and  well.  The  family  history  is  otherwise 
uncertain. 

In  appearance  the  patient  appears  to  be  well  nourished  and  is  of 
average  height  and  weight.  In  spite  of  this  tremendous  diuresis  he  says 
that  he  probably  gained  in  weight  during  this  last  year  about  ten  pounds. 
A  thorough  examination  of  the  chest  and  abdomen  was  negative  as  to 
any  pathologic  finding.  There  is  no  hypertrophy  of  the  left  ventricle 
of  the  heart  and  there  is  no  accentuation  of  its  second  sound.  The  qual- 
ity of  the  pulse  is  normal  in  all  respects.  There  is  no  enlargement  of 
the  kidneys  nor  of  other  abdominal  organs. 

In  regard  to  treatment,  drugs  seemed  to  be  of  little  or  no  value. 
Bromide  of  soda  with  the  elixir  of  valerianate  of  ammonia,  the  solution 
of  the  bromide  of  gold  and  arsenic  in  increasing  doses  to  twenty-eight 
drops  three  times  daily,  were  tried  without  avail.  Adrenalin,  beginning 
with  ten  drops  (placed  in  the  sub-lingual  space  and  allowed  to  be  ab- 
sorbed from  there)  and  increasing  to  thirty  drops  three  times  daily,  gave 
negative  results.  His  diet  and  the  quantity  of  fluid  which  was  taken, 
was  not  restricted.  His  chief  idea  in  taking  medicine  was  to  overcome 
this  excessive  diuresis  and  intense  thirst,  as  it  seriously  interfered  with 
his  daily  vocation. 

In  reviewing  some  of  the  literature  on  this  interesting  condition, 
one's  attention  is  immediately  drawn  to  the  comparative  rarity  of  this 
disease.  Osier  in  his  "Practice  of  Medicine,"  mentions  that  out  of  a 
total  of  239,000  patients  treated  at  Johns  Hopkins  Hospital  and  Dispen- 
sary, there  were  but  three  cases  of  diabetes  insipidus. 

There  is  much  uncertainty  in  regard  to  the  etiology.  Diseases  of 
the  nervous  system,  tumors  of  the  brain,  sunstroke,  cerebro-spinal 
fever,  traumatism  of  the  head,  fright,  syphilis,  etc.,  have  been  men- 
tioned. Bernard's  discovery,  the  puncture  oi  the  floor  of  the  fourth 
ventricle  above  the  diabetic  center,  which  resulted  in  an  increased 
secretion  of  non-saccharine  urine  may  account  for  certain  cases  where 
history  records  cerebral  diseases  or  traumatism  of  the  head.  Irri- 
tation of  the  sympathetic  ganglia  of  the  abdomen  local  irritation  at- 
tending the  presence  of  abdominal  tumors,  aneurism,  etc.,  may  cause  a 
train  of  symptoms  resembling  diabetes  insipidus,  but  these  are  undoubt- 
edly cases  of  simple  diuresis  or  polyuria  and  should  not  be  classified  with 
the  subject  under  discussion.  Young  persons  are  most  frequently  af- 
fected. This  condition  is  more  often  found  in  males  than  females.  An 
hereditary  tendency  has  been  noted  in  many  instances. 

Pathologic  anatomy  shows  that  there  are  no  constant  lesions. 
That  the  kidneys  have  been  found  enlarged  and  congested,  that  the 
pelves  of  the  kidneys  and  the  ureters  should  be  dilated,  and  that  there 
should  be  hypertrophy  of  the  bladder,  is  not  strange  when  one  stops 
to  consider  the  great  and  continual  irritation  under  which  these 
changes  have  been  brought  about.  Chemical  analyses  of  the  blood 
have  shown  a  moderate  increase  of  the  solid  constituents  in  proportion 
to  the  water.  As  to  the  urine  there  is  only  an  increase  of  water  while 
the  quantity  of  the  natural  ingredients  remains  about  the  same  as  in 
health. 


METCALF:       CLINIC  157 

The  prognosis  depends  almost  entirely  upon  the  nature  of  the 
causes  and  complications.  Cases  of  four  months  to  fifty  years  duration 
are  on  record.  Some  intercurrent  disease  is  generally  the  cause  of  death. 
Cases  of  recovery  have  been  reported,  and  spontaneous  cures  may  take 
place;  but  v^here  these  occur,  the  duration  is  generally  within  one  year 
and  is  independent  of  treatment. 

270  Woodward  Ave. 

DR.  METCALF'S  CLINIC. 

At  Harper  Hospital,  December,  7th,  8th  and  9th,  1904. 

REPORT    OF    OASEIS— CotM-riiMUEo 

Case  XII.  Fibroid  of  uterus.  Metritis.  Vaginal  hysterectomy. 
fDec.  8th,  11:30  to  12:30.) 

Mrs.  M.,  aet.  39.  Family  history  negative.  Menses  began  at  14;  regular  and 
5  days  in  duration.  Dysmenorrhoea,  with  fainting  and  vomiting  during  the  first 
day.  Fifteen  years  ago  was  in  hospital  14  months  "because  of  rheumatism  follow- 
ing typhoid  infection  of  the  bladder."  Left  knee  remained  stiff.  Has  three  chil- 
dren, the  oldest  11  and  the  youngest  4  years  old.  Has  had  two  miscarriages;  last 
one  was  at  two  and  a  half  months  and  was  two  years  ago.  Following  first  miscar- 
riage, five  years  ago,  had  sepsis  and  was  in  bed  three  months.  Was  again  con- 
fined to  her  bed  through  August  and  September  last  with  peritonitis.  (Compare 
Case  IX  in  this  connection.)  Patient  now  has  aching  through  top  and  back  of 
head  and  in  eye-balls;  feels  as  though  head  were  being  constantly  drawn  back- 
ward. She  has  constant  pain  and  soreness  in  abdomen,  which  is  always  tympani- 
tic. Suffers  from  dyspepsia  and  obstinate  constipation,  coldness  of  hands  and  feet 
and  insomnia.  Vaginal  hysterectomy  was  now  performed;  the  uterus  was  found 
large  and  contained  a  fibroid  in  the  anterior  wall  at  the  junction  of  the  cervix  with 
the  body  of  the  organ.  Both  ovaries  had  undergone  cystic  changes.  Pathological 
examination  of  the  uterus  showed  advanced  interstitial  endometritis  and  extensive 
fibrous  deposits  in  the  outer  muscular  layer.  Besides  the  one  developed  fibroid, 
there  were  other  small  ones  found  in  the  microscopic  section.  The  tubes  were  the 
seat  of  large  deposits  of  fibrous  tissue  and  increase  of  blood-vessels  with  thickened 
walls.  The  plicae  were  edematous  and  contained  some  increase  of  small  cells. 
The  ovaries  showed  a  greatly  thickened  tunica  albuginea. 

There  were  many  areas  of  hyaline  degeneration,  the  blood-vessels  were  increasd 
and  had  thickened  walls,  and  there  were  old  follicular  cysts.  The  reactionary  tem- 
perature reached  101.  but  subsided  in  a  few  hours;  the  highest  pulse-rate  was  100. 
Both  pulse  and  temperature  remained  normal  after  the  6th  day.  The  patient  sat 
up  on  the  13th  day  but  remained  in  the  hospital  until  Jan.  7th,  when  she  appeared 
to  be  in  good  condition.  On  June  lst,she  was  reported  to  be  in  good  health,  her 
greatest  annoyance  being  the  "hot  fiashes"  that  regularly  follow  for  a  time  the 
removal  of  the  adnexae.  She  had  been  doing  her  own  house-work  for  the  past  two 
months. 

Case  XIII.  Extensive  obstructing  fibro-lipoma  surrounding  the 
rectum  and  sigmoid  flexure.  (Removal  at  operation,  Dec.  5th ;  exhibited 
in  chnic,  Dec.  8th.) 

Mrs .  F.,  aet.  59.  Tuberculosis  on  the  maternal  side.  Menses  began  at  14. 
Married  at  15;  had  six  children;  one  miscarriage  at  7  months;  not  pregnant  since. 
Menopause  at  46.  Complained  lately  of  backache,  aching  in  back  of  head,  and  dis- 
tress in  lower  abdomen;  constipation,  dyspepsia,  tympanites,  and  frequent  urina- 
tion more  especially  in  the  day  time.  The  constipation  had  been  increasing  grad- 
ually until  of  late  even  enemata  were  with  difficulty  effective.  Three  days  ago 
this  patient  was  placed  in  the  Trendelenburg  position;  exploratory  median  ab- 
dominal incision  was  made,  and  a  new-growth  found  surrounding  the  sigmoid  fiex- 
ure  of  the  colon  and  upper  rectum,  crowding  upon  the  pelvic  organs,  and  adhering 
to  the  uterus.  The  growth  is  of  the  nature  of  a  fibrolipoma,  starting  between  the 
two  layers  of  the  mesentery  and  spreading  around  the  bowel  so  that  the  latter  is 
practically  buried  in  the  mass  of  rather  dense  fat.  The  cross-section  of  the  growth 
surrounding  the  bowel  varied  from  8cm.  by  6cm.  to  6cm.  by  5cm.,  and  the  whole 
was  increased  by  numerous  epiploic  appendages  engorged  with  fat.  The  bowel, 
thus  encumbered  for  a  distance  of  28cm.  (about  11.  inches),  upward  from  the  mid- 
dle of  the  rectum,  became  in  the  aggregate  a  tumor  of  threatening  proportions. 


158  DETROIT     MEDICAL     JOURNAL 

At  no  part  of  the  bowel  thus  compressed  was  any  definite  malignant 
histological  change  engrafted  upon  the  moderate  hyperplasia  of  the 
mucosa.  It  cannot,  however,  be  overlooked  that  the  lipoma  was  attain- 
ing a  size  which  not  only  must  be  considered  in  relation  to  the  bowel 
itself  ,  but  would  eventually  threaten  life  by  interference  with  other  or- 
gans. The  bladder  had  already  resented  its  presence.  The  removal  of 
the  ordinary  pedunculated  lipomata  of  the  rectum  described  in  the  text- 
books presents  some  difficulty  if  we  proceed  upon  entirely  safe  ground, 
but  it  will  readily  be  seen  how  absolutely  impossible  it  would  be  to  have 
removed  the  growth  here  involved  by  any  means  calculated  to  preserve 
the  integrity  of  that  portion  of  bowel  contained  within  it.  Accordingly 
the  colon  was  amputated  about  five  inches  above  the  sigmoid  flexure,  the 
iumen  having  been  closed  with  forceps  above  and  below  the  line  of  in- 
cision. The  lower  end  of  the  proximal  portion  being  wrapped  in  gauze, 
the  mesentery  and  mesorectum  were  ligated  progressively  downward 
and  the  rectum  amputated  at  a  point  as  low  in  the  pelvis  as  accessible. 
The  upper  end  of  the  amputated  rectum  was  now  grasped  by  large  for- 
ceps passed  through  the  anus  and  by  inversion  drawn  outward  through 
this  opening.  Next  an  artificial  anus  was  made  in  the  usual  location  for 
inguinal  colostomy,  the  lower  cut  end  of  the  proximal  portion  of  the 
bowel  being  brought  up  and  stitched  into  the  opening.  The  denuded 
area  in  the  pelvis  was  packed  loosely  with  iodoform  gauze  with  end 
pushed  downward  into  anus  and  the  abdominal  wound  closed.  The  pa- 
tient was  then  placed  in  the  lithotomy  position,  the  sphincter  cut  pos- 
teriorly, and  the  remaining  portion  of  the  rectum  removed.  The  end  of 
gauze  placed  from  above  was  brought  out  and  other  gauze  added  to  as- 
sist drainage.  The  recovery  was  uneventful  except  for  a  limited  suppUr 
ration  in  the  abdominal  wound,  infection  reaching  it  from  the  colostomy 
wound.  Highest  temperature,  102.4;  highest  pulse-rate,  100.  The  tem- 
perature was  normal  after  Dec.  23rd.  She  left  the  hospital  Jan.  14th  in 
good  condition.  The  artificial  anus  needed  subsequent  dilatation,  which 
was  done  by  her  attending  physician.  She  is  now  (June  5th)  in  good 
health  and  a  daughter  reports  that  the  patient  has  good  control  of  bowel 
movements  except  during  catharsis. 

Lipomata  are  ordinarily  attached  to  the  rectal  wall  and  they  more 
often  assume  a  polypoid  character.  They  are  composed  of  fat-cells  en- 
closed in  a  fibrous  stroma  and  their  vascularity  ordinarily  is  not  great. 
"Vorchung  (Trans.  Path.  Soc.  Lond.,  vol.  XV,  p.  100),  has  reported  a 
case  seen  in  a  woman  who  had  suffered  during  life  from  retention  of 
faeces  and  difficulty  in  urination.  She  died  from  mechanical  obstruction 
to  the  passage  of  urine.  Upon  post-mortem  there  was  found  a  lipoma 
in  the  pelvis  completely  surrounding  the  rectum  and  firmly  attached  to 
its  outer  walls.  The  growth  entirely  obstructed  the  two  ureters  and  al- 
most completely  occluded  the  rectum." — Diseases  of  the  Anus,  Rectum, 
and  Pelvic  Colon;  James  P.  Tuttle;  p.  718. 

Case  XIV.  Obstruction  of  cystic  duct  by  enlargement  of  a  lymph- 
gland  at  the  angle  between  it  and  the  hepatic  duct.  (Dec.  8th,  12 130  to 
1 130  P.  M.) 


METCALF:        CLINIC  159 

Mrs.  S.,  aet.  49.  Family  history  negative.  Matured  at  13;  dysmenorrhoea 
severe.  Married  at  22;  two  children,  ages  25  and  21.  Her  suffering  during  men- 
struation continued  throughout  menstrual  life.  Menopause,  eight  months  ago. 
She  has  had  discomfort  in  region  of  gall-bladder  for  last  15  years.  Is  just  recover- 
ing from  last  attack,  which  began  six  weeks  ago.  The  intervals  were  formerly  of 
two  or  three  months  duration;  of  late  the  discomfort  is  almost  constant.  Has  had 
chills,  sweating,  and  nausea  during  last  attack;  also  referred  pain  to  median  side  of 
right  shoulder-blade.  Complains  of  coldness  and  constipation.  Examination  of 
urine,  negative;  incomplete  examination  of  stomach  contents  showed  HCl  present; 
haemoglobin,  reduced  to  60.  per  cent.  No  pelvic  examination  before  she  was 
brought  into  clinic.  Exploratory  incision  in  the  right  hypochondrium.  Gall-blad- 
der found  to  be  filled  with  fluid,  which  could  not  be  forced  out  into  common  duct, 
the  cystic  duct  being  obstructed  by  an  enlarged  lymph-node,  of  the  size  of  a  small 
olive,  in  the  angle  at  the  junction  of  the  cystic  and  hepatic  ducts,  together  with  a 
congestive  thickening  of  the  mucosa.  The  gall-bladder  measured  10.  cm.  in  length 
and  was  of  paler  color  than  normal.  There  were  a  few  adhesions  apparently  of  re- 
cent origin.  The  fluid  contents  were  removed  by  means  of  the  aspirator,  and  a 
thick,  brownish,  semi-transparent,  mucous  fluid  was  thus  evacuated;  an  opening 
was  made  in  the  fundus,  but  no  stones  were  found;  and  a  double  drainage-tube  was 
stitching  into  the  opening  made,  and  the  organ  brought  up  to  the  parietal  peri- 
toneum. 

The  patient  was  anaemic  and  I  felt  this  a  safer  procedure  at  this  time 
than  cholecystectomy.  I  believed  that  by  drainage  in  this  case  the  en- 
larged lymph-gland  would  become  smaller,  and  this  was  afterward  found 
to  be  so.  Her  immediate  recovery  was  uneventful,  her  highest  tempera- 
ture being  99.8,  and  highest  pulse-rate,  100.  She  left  the  hospital  Dec. 
3Tst,  apparently  greatly  improved,  and  with  the  wound  entirely  healed. 
After  being  up  and  about  for  a  time  she  was  again  annoyed  by  a  trouble- 
some dragging  pain  in  the  lower  abdomen ;  she  returned  to  Harper  Hos- 
pital on  April  8th.  On  making  the  pelvic  examination,  which  had  been 
omitted  in  the  clinic,  partly  for  lack  of  time,  and  partly  for  absence  of 
positive  indications  in  the  history  obtained,  ample  cause  was  disclosed 
for  her  present  discomfort — a  different  train  of  symptoms,  however,  as 
Avill  be  observed,  from  the  periodic  attacks  which  had  formed  her  chief 
complaint  on  the  occasion  of  her  former  visit  to  the  hospital.  The  uterus 
was  sub-involuted  and  retroverted,  and  its  appendages  were  firmly  ad- 
herent.   Abdominal  hsyterectomy  was  performed. 

Pathological  report:  Chronic  interstitial  endometritis.  Hyaline  de- 
generation of  ovaries,  together  with  increase  of  their  blood-vessels  and 
fibrous  tissue;  all  these  changes  extensive.  Occasional  old  follicular 
cyst.    Absence  of  Graafian  folicles. 

Occasion  was  taken  at  this  time  to  examine  the  gall-bladder.  It  was 
found  to  contain  a  small  quantity  of  bile,  which  could  be  readily  pressed 
through  the  cystic  duct.  The  gland  which  formerly  had  caused  the  ob- 
struction had  become  reduced  in  size,  measuring  2  mm.  by  3  mm.  by  4 
mm.  The  new-formed  ligament,  attaching  the  gall-bladder  to  the  ab- 
dominal wail,  was  about  2.5  cm.  long  with  omentum  adhering  about  it. 
The  temperature  rose  to  102.  on  April  19th,  on  account  of  infection  in 
the  abdominal  wound ;  it  remained  normal  after  April  27th.  She  left  the 
hospital  May  nth  with  the  abdominal  wound,  although  clean,  yet  not 
completely  healed,  the  process  of  granulation  being  very  slow.  On  June 
I2th,  her  family  physician  reported  thkt  she  was  apparently  well,  but  that 
the  wound  had  been  slow  in  heaHng. 


160  DETROIT     MEDICAL     JOURNAL 

Case  XV.  Partial  atresia  of  the  anus,  congenital.  Phimosis.  (Dec. 
8th,  1:30  to  2:30.) 

Baby  I.,  aet.  1  year.  This  baby  is  healthy  and  perfectly  developed  with  the 
exception  that  instead  of  the  normal  anus  there  is  a  small  linear  opening  anterior 
to  normal  position.  Through  this  opening,  defecation  has  been  accomplished  with 
diflSculty  by  the  aid  of  a  syringe. 

In  cases  where  the  occlusion  is  complete  or  nearly  so,  operation 
should  be  performed  at  once,  on  the  first  or  second  day  of  life,  before 
ileus  begins  to  appear.  In  some  cases  the  atresia  is  complete  and  in  such 
an  artificial  anus  must  be  made.  This  case  is  a  simple  one  to  correct,  but 
I  will  use  the  same  method  as  though  there  were  complete  occlusion  by 
a  thin  membrane,  viz.,  an  antero-posterior  incision.  Through  this  in- 
cision the  rectum  is  emptied  and  washed,  the  redundant  tissue  trimmed 
away,  and  the  edge  of  the  mucosa  brought  down  and  stitched  to  the  skin. 
1  do  not  need  to  cut  through  the  sphincter  in  this  case. 

In  performing  the  circumcision,  I  first  dilate  the  prepuce  with  these 
fine-pointed  forceps,  retract  the  foreskin,  partially  clip  the  frenum,  so 
that  the  glans  penis  will  not  be  drawn  downward.  The  foreskin  is  then 
pulled  forward  over  the  glans,  as  in  its  original  position ;  a  tenaculum  is 
hooked  from  within  outward  through  the  mucous  membrane  at  both  the 
frenal  and  the  dorsal  sides.  The  foreskin  is  then  put  upon  some  stretch 
by  pulling  forward  upon  the  tenacula.  A  narrow  bistoury  blade  is  then 
passed  from  side  to  side  through  the  center  of  the  foreskin  at  the  tip  of 
the  glans  and  carried  through,  severing  the  frenal  half.  With  a  scissor 
curved  upon  the  flat,  the  other  half  is  incised  upward  over  the  dorsum. 
In  this  way  just  enough  mucous  membrane  and  skin  are  removed.  The 
edge  of  the  mucous  membrane  is  then  stitched  to  the  edge  of  the  skin, 
the  stitch  encircling  the  artery  of  the  dorsum  and  of  the  frenum ;  or  in- 
terrupted sutures  may  be  used.  Swelling  and  annoying  erections  are 
caused  by  constriction  of  the  veins  behind  the  glans  and  both  may 
be  prevented  by  pulling  the  shortened  foreskin  forward  over  the  glans 
and  keeping  it  there  for  three  or  four  days  by  passing  a  catgut  suture 
through  the  center  of  the  foreskin  from  side  to  side  and  tying  it  above 
the  meatus  in  this  position.  To  prevent  the  formation  of  adhesions  be- 
tween the  glans  and  the  inner  surface  of  the  prepuce,  a  layer  of  collo- 
dion, or  "liquid  court-plaster"  may  be  interposed.  Attention  to  these 
minor  details  will  keep  the  baby  comfortable. 

The  baby  left  the  hospital  on  Dec.  12th,  and  the  attending  physician 
on  April  17th  reported  that  the  results  were  satisfactory  and  the  child 
was  well. 

Case  XVI.  Cholecytitis  and  chronic  pancreatitis.  Mayo  Robson- 
Cammidge  test  positive.  Cholecystectomy.  (Operation  Oct.  22nd ;  ex- 
hibition in  chnic  Dec.  8th,  for  purpose  of  comparison  with  Cases  V.  and 
XIV.) 

Mrs.  M.,  aet.  42.  Father  died  of  cancer  of  the  rectum.  One  paternal  aunt 
died  of  cancer.  Patient  matured  at  13;  normal;  married  at  21;  two  children,  ages 
20  and  13 ;  two  miscarriages,  last  one  ten  years  ago.  She  was  sick  for  four  months 
after  her  first  miscarriage.  Lacerations  were  repaired  three  years  ago.  She  had 
Suffered  pain  in  the  epigastrium  since  childhood.  Intervals  between  such  attacks 
would  sometimes  be  six  months.  About  two  and  a  half  years  ago  she  suffered  so 
much  from  gastric  disturbance  that  she  underwent  lavage  for  some  time  at  the 
hands  of  a  specialist.    Another  stomach  specialist  advised  her  to  eat  much  fat.    A 


METCALF.        CLINIC  161 

surgeon  had  told  her  that  she  could  not  have  gall-stones  because  she  did  not  have 
jaundice,  wherein  he  assumed  to  disagree  with  a  general  practitionr  who  had  been 
in  the  case.  Later,  two  years  ago,  she  had  the  gall-bladder  drained  by  another 
surgeon  and  gall-stones  were  removed.  The  drainage  canal  had  not  closed  at  the 
end  of  a  year.  The  fistulous  tract  had  then  been  dissected  out  and  the  wound  was 
closed,  but  it  did  not  remain  so.  Another  surgeon  operated  upon  the  rectum  and 
curetted  the  uterus  "to  cure  her  indigestion."  He  repeatedly  cauterized  the  fistu- 
lous tract  leading  into  the  gall-bladder  and  applied  X-ray  and  massage  to  the  epi- 
gastric region.  When  she  first  came  to  me,  Oct.  18th,  1904,  the  fistula  had  been 
closed  for  six  weeks;  she  was  having  attacks  of  severe  colicky  pain  every  day  or 
two,  but  without  nausea.  Her  temperature  ranged  from  99.  to  102.  She  was  sent  to 
the  hospital  and  shortly  afterward  has  a  severe  chill.  On  Oct.  22nd,  I  made  an  in- 
cision which  disclosed  the  gall-bladder,  gangrenous  in  patches  and  filled  with  pus; 
its  walls  were  greatly  thickened.  The  head  of  the  pancreas  was  four  times  its 
normal  thickness  and  harder  than  normal.  Considering  the  pancreatitis,  the  indi- 
cation was  to  use  the  gall-bladder  as  a  drainage-tract,  but  on  account  of  its  gangren- 
ous condition  I  performed  cholecystectomy,  sewing  a  drainage-tube  over  the  end 
of  the  cystic  duct  without  ligating  the  duct  itself.  Her  highest  temperature  sub- 
sequent to  operation  was  100.6.  On  Nov.  19th,  she  left  the  hospital  with  the  wound 
healed.  On  Nov.  26th,  she  again  complained  of  severe  pain  and  for  about  two 
weeks  was  again  under  observation,  although  there  was  no  reopening  of  the  wound. 
On  May  15th,  at  a  casual  meeting,  the  patient  reported  that  after  the  middle  of 
December  she  had  had  occasional  discomfort  in  the  region  of  the  stomach  and  gall- 
bladder, but  for  some  time  past  has  been  comfortable;  and  she  appears  well. 

Shortly  after  the  operation  upon  this  patient,  a  specimen  of  urine 
was  sent  to  the  Detroit  Clinical  Laboratory  to  be  tested  by  the  method 
pubHshed  recently  by  Cammidge,  working  with  and  indorsed  by  Mayo 
Robson.  The  method  is  claimed  to  detect  the  glycerine  thrown  into  the 
urine  as  a  result  of  the  metabolic  change  induced  by  altered  pancreatic 
function.  In  our  case  it  was  rather  a  test  of  the  method  than  a  means  of 
diagnosis,  but  it  is  of  interest  to  note  that  the  report  was  positive. 

Case  XVn.  Fecal  fistula.  Sponge  in  the  abdomen.  (Dec.  8th,  2  145 
to  4 130  P.  M.) 

Miss  C,  aet.  28.  Maternal  grandmother  died  of  cancer  of  the  breast.  Men- 
struation began  at  14;  duration  one  week;  regular;  dysmenorrhoea,  with  great 
suffering  the  first  day.  Profuse  leucorrhoea  for  last  .five  years.  Had  pneumonia 
two  years  ago;  fully  recovered.  In  June  last,  another  surgeon  performed  ventro- 
suspension  to  relieve  retroversio  uteri.  The  incision  apparently  healed  but  on 
the  13th  day  following  the  operation  a  fecal  fistula  appeared  in  the  median  line 
15.  cm.  above  the  symphysis  pubis.  Besides  the  annoyance  of  this  fistula,  patient  is 
now  suffering  from  backache,  pain  in  right  ovarian  region,  and  nausea  after  eating. 
A  median  incision  is  now  (Dec.  8th)  made  through  the  abdominal  wall  above  the 
fistula;  abdominal  contents  protected  by  towels;  and  incision  extended  downward 
around  both  sides  of  fistulous  tract.  Intestinal  coils  and  omentum  were  found  ad- 
herent to  abdominal  wall  about  region  of  fistula.  When  these  adhesions  were  sepa- 
rated, a  gauze  sponge  was  found  lying  in  the  center  of  the  mass.  Against  the 
under  side  of  the  sponge,  lay  the  caecum  and  ileum.  Somewhat  above  the  ileo- 
caecal  valve  was  a  circular  opening  into  the  colon  4.  cm.  in  diameter.  There  was 
also  an  opening  in  the  ileum  near  its  caecal  junction.  The  sponge  was  already 
partly  in  the  colon  and  might  soon  have  been  discharged  per  rectum.  The  open- 
ings into  the  intestines  were  repaired,  with  celluloid  linen,  the  line  of  suture  being 
transverse  to  the  long  diameter  of  the  bowel.  The  mass  of  infected  omentum  and 
the  cicatricial  tissue  in  the  abdominal  wall  were  dissected  away.  Examination 
of  the  pelvic  contents  was  then  made.  The  peritoneal  band  formed  in  the  effort  to 
suspend  the  uterus  had  been  stretched  into  a  mere  thread  and  gave  no  support. 
The  right  ovary  was  changed  into  a  cyst  of  the  size  of  a  hen's  egg.  The  left  ovary 
contained  a  cyst  of  the  size  of  a  cherry.  The  right  ovary  was  removed;  the  cyst 
was  removed  from  the  left;  the  uterus  was  suspended  by  a  shortening  of  the  round 
ligaments  by  the  method  described  by  Gilliam,  of  Columbus,  Ohio;  and  the  abdom- 
inal wound  was  closed. 

On  the  6th  day,  the  temperature  rose  to  101.6  and  pulse  to  100.,  when 
pus  was  found  in  the  lower  angle  of  the  abdominal  wound;  infection, 


^62 


DETROIT    MEDICAL     JOURNAL 


bacillus  coli.  Subsequently  nearly  the  whole  wound  opened.  More  or 
less  elevation  of  temperature  continued  until  the  12th  day,  when  indura- 
tion was  discovered  in  the  cul-de-sac  of  Douglas  through  the  porterior 
vaginal  vault.  Free  incision  was  made  through  the  latter  and  the  pus 
evacuated.  After  this  the  patient  made  an  uneventful  recovery.  She 
remained  in  the  hospital  until  Jan.  i8th,  the  process  of  granulation  in  the 
abdominal  wound  being  slow.  At  the  middle  of  April,  her  family  physi 
cian  reported  as  follows :  "I  called  upon  Miss  C.  today  and  find  her  10 
be  feeling  very  well  indeed.  She  seems  much  better  than  before  her  first 
operation,  and  it  is  needless  to  say  they  are  well  satisfied." 


ANEURYSM  FROM  BULLET-WOUND. 

By  G.   L.   CRUICKSHANK.  M.  D.,  Windsor,  Ont., 

and 

P.   M.   HICKBY,   M.   D.,   Detroit. 


On  the  morning  of  Jan.  6th,  1905,  Sergt.  Nash,  while  arresting  a 
burglar  in  Windsor,  was  shot  in  the  neck  by  a  32-calibre  revolver  at  a 
distance  of  about  six  inches.  The  bullet  went  through  his  collar  and 
entered  the  neck  through  the  sterno-mastoid,  about  one  ince  above  and 
half  an  inch  exterior  to  the  right  sterno — clavicular  joint,  in  a  direction 
backwards  and  slightly  downwards  and  outwards.  It  did  not  emerge. 
The  officer  staggered  and  his  right  arm  fell  temporarily  paralyzed.  There 
was  very  little  hemorrhage.  In  ten  or  fifteen  minutes  the  wound  was 
cleansed  and  dressed  in  campho-phemquos.  No  probing  was  done.  On 
the  8th  a  decided  thrill  could  be  felt  over  the  wound  and  in  the  line  of 
the  carotid — and  outwards  towards  the  shoulder. 

Jan.  8th,  in  consultation  with  Dr.  McGraw,  of  Detroit,  and  Dr.  Cas- 
grain,  of  Windsor,  it  was  decided  that  the  thrill  emanated  from  an  aneur- 


STAPLETON:       MYOCLONUS     MULTIPLEX  163 

ism  of  the  thyroid  axis  and  should  not  be  operated  upon.  The  thrill  by 
this  time  was  very  strong  above  the  outer  third  of  the  clavicle  in  the  posi- 
tion of  the  transverse  cervical  and  the  supracapular  arteries.  The  thrill 
was  not  perceptible  at  the  angle  of  the  jaw,  but  the  sound  was  very  dis- 
tinct. The  fourth  and  fifth  fingers  of  the  right  hand  could  be  moved  but 
very  little. 

The  patient  was  kept  rigidly  in  bed  on  a  very  light  diet  and  given 
depresents  for  a  month.  By  this  time,  the  thrill  was  very  much  less.  On 
Feb.  20th,  Dr.  Hickey  made  an  x-ray  examination  in  order  to  locate  the 
bullet.  The  patient  being  very  heavily  built  is  was  impossible  to  take 
the  radiograph  except  in  an  anterio-posterior  position,  which  would  not 
give  a  definite  idea  as  to  its  depth.  Accordingly  the  x-ray  was  taken 
stereoscopically.  The  combined  negatives  showed  that  the  bullet  is 
lodged  in  the  deep  muscles  of  the  back  just  below  the  scapula. 

May  19th,  Sergt.  Nash  is  on  duty  every  day.  There  is  no  apparent 
tremor — the  thrill  is  slight.  There  is  no  noise  in  his  ear.  The  fing/jrs 
and  arm  have  regained  considerable  strength. 


REPORT  OF  CASE  OF  MYOCLONUS  MULTIPLEX  (PARAMY- 
OCLONUS—CONVULSIVE  TREMOR.) 

By  WM.  J.  STAPKETON.  JR.,  M.  D. 
Detroit, 


On  April  21,  1905,  at  2  p.  m.,  the  ambulance  brought  to  the  hospital 
a  man  who  had  fallen  in  the  street  in  a  fit.  The  following  history  was 
obtained.  Name ;  weight,  180  lbs. ;  height,  6  ft.  i  in. ;  occupation,  pugil- 
ist— ex-soldier;  at  present,  no  occupation. 

Further  questioning  showed  that  he  had  been  extremely  active  in 
the  athletic  line,  especially  boxing  and  bag  punching.  Had  held  cham- 
pionship at  one  time  in  bag  punching.  Had  served  in  the  United  States 
Army,  31st  Regulars  for  eight  months,  seeing  service  in  Cuba  and  Phil- 
ippines. 

On  Dec.  27,  1904,  while  lying  on  his  back  at  home,  his  right  leg  be- 
came stiff  and  he  had  a  convulsion — since  then  hardly  a  day  passes  that 
he  does  not  experience  one.  These  attacks  come  on  without  warning. 
There  is  a  sudden  contraction  of  the  trunk  and  hip  muscles,  which 
cause  the  body  to  be  alternately  flexed  and  extended  so  violently  that  he 
is  sometimes  thrown  from  a  chair,  if  he  is  sitting.  In  some  of  the  at- 
tacks the  whole  body  is  involved.  He  does  not  become  unconscious — 
never  bites  his  tongue,  no  vomiting  or  inconvenience.  The  spasmodic 
movements  are  bilateral.  During  the  last  seven  years  he  has  been  a 
steady  drinker,  and  now  drinks  to  ward  off  the  attacks. 

The  pathology  of  this  disease  is  unknown.  Diagnosis  is  based  upon 
the  peculiar  character  of  the  spasm,  on  the  fact  that  the  trunk  muscles 
are  involved  and  that  the  spasms  are  bilateral.  Duration  is  from  a  few 
months  to  years.  Prognosis  is  said  to  be  good.  Treatment — -tonics  and 
chloral.    Electricity  and  hydrotherapy  are  said  to  be  beneficial. 

176  Lafayette  Boul. 


164  DETROIT    MEDICAL   JOURNAL 

DETROIT  MEDICAL  JOURNAL 


A    MONTHLY    EPITOME    OF   PRACTICE   AND  THERAPEUTICS 


HERBERT  M.  RICH,  M.  D.,  Managing  Editor 

COLLABORATORS— Frank  Burr  Tibbals,  M.  D.,  Augustus  Wright  Ives,  M.  D.,  Joseph 
Sill,  M.  D.,  Henry  Jasper  Hartz,  M.  D.,  Don  M.  Campbell,  M.  D.,  Preston  M. 
Hickey,  M.  D.,  Burt  Russel  Shurly,  M.  D.,  Richard  R.  Smith,  M.  D.,  Grand  Rapids, 

J.  F.  HARTZ,  Business  Manager. 

Subscription    Price,   $1.00   per   Year.     Single   Copies,   15   Cents. 
NoTB.— W«  do  not  assum*  responsibility  for  the  opinions  of  contributors. 

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Requests  for  reprints  should  accompany  manuscript. 

Address  all  communications  to  103  and  105  Miami  Avenue.  Detroit,  Michigan,  U.S.A. 

Vsl.  5.  DETROIT,  MICHIGAN.  AIGUST,  1905.  N*.  5. 

An  Opportune  Epidemic. 

Much  as  we  deplore  the  suffering  and  loss  of  liTe  in  the  prevailing 
yellow  fever  epidemic  of  Louisiana,  it  seems  pro^  .dentially  sent  with  a 
message,  and  if  this  message  be  properly  interpreted  by  the  medical  pro- 
fession, results  will  follow  making  the  epidemic  no  unmitigated  curse, 
The  good  to  be  accomplished  may  be  divided  into  three  general  heads. 
In  the  first  place,  we  are  promised  that  the  city  of  New  Orleans  shall  be 
thoroughly  cleaned.  This  means  the  saving  of  many  lives  from  other 
diseases  than  yellow  fever.  It  means  another  American  municipality, 
getting  a  lesson  in  public  health,  the  only  sort  of  lesson  they  ever  seem 
ro  heed.  ^ 

A  second  result  will  be  the  popular  appreciation  of  what  the  work 
of  Gen.  Leonard  Wood  and  his  medical  associates  in  Cuba  meant,  and 
what  the  present  results  in  Panama  are.  The  average  number  of  deaths 
per  day  in  the  Louisiana  epidemic  has  been  greater  than  the  average  per 
month  in  the  Canal  Zone  under  American  control. 

Finally,  what  more  forcible  argument  for  a  National  Board  of 
Health  can  be  brought  than  the  present  "shot-gun  quarantine"  of  Louisi- 
ana by  her  sister  states?  It  deserves  a  place  beside  Lynch-law  and  the 
Vigilance  Committees  of  horse-thief  days  on  the  frontier.  It  is  to  be 
hoped  that  the  legislative  committee  of  the  American  Medical  Associa- 
tion who  are  presenting  to  Congress  the  need  of  a  National  Board  of 
Health,  will  not  fail  to  push  home  the  lesson  of  this  epidemic.  We  have 
national  commissions  to  regulate  inter-state  commerce,  immigration,  and 
a  host  of  other  things.  We  have  a  whole  department  of  the  government 
with  a  Cabinet  officer  devoted  to  the  care  of  our  agriculture,  making 
constant  warfare  on  the  parasites  of  our  plant  life.  But  when  a  human 
parasite,  like  the  yellow-fever  germ,  begins  to  devastate  human  life  the 
National  government  is  powerless  and  each  man  must  stand  before  his 
own  home  with  a  shot-gun,  while  sister  states  of  this  Union  are  arrayed 
against  each  other  with  armed  troops  on  their  borders  by  order 
of  the  governors  of  the  states.  It  should  be  pointed  out  in  this  connec- 
tion, also,  that  this  sort  of  epidemic  control  is  as  ineffective  as  it  is  crude 


EDITORIAL  165 

because  the  mosquito,  the  real  bearer  of  the  disease,  can  not  be  kept  away 
by  a  shot-gun. 

The  Public  Schools  and  Medicine. 

Of  87  school  children  named  as  "dull"  in  the  Dundee*  (England) 
schools,  43  showed  deafness,  mostly  marked;  69  had  visual  defects;  37 
had  adenoids  or  enlarged  tonsils,  or  both.  Among  other  ailments  found 
in  this  class  were  bronchitis,  eczema,  impetigo,  tinea,  adenitis,  heart 
lesions  of  various  kinds,  chorea  and  rickets.  Not  one  was  physically 
"fit." 

These  are  not  the  first  figures  which  have  shown  that  there  is 
usually  a  physical  basis  for  the  gross  dullness  of  children  in  school,  but 
they  are  at  hand  and  serve  to  illustrate  one  phase  of  the  question  which 
is  coming  to, the  consciousness  of  the  city  of  Detroit  more  and  more 
each  year.  That  is  the  question  of  the  medical  inspection  of  school. 
The  Health  board  of  the  city  have  already  taken  the  matter  up  and  are 
consistently  carrying  it  forward.  But,  as  stated  by  Health  Officer 
Kiefer  in  his  paper  before  the  State  Medical  Society  at  Petoskey,  this 
•is  only  a  beginning.  The  inspection  of  schools  with  the  idea  of  eliminat- 
ing infectious  diseases  is  the  merest  rudiment  of  the  work  in  question. 

In  spite  of  the  great  amount  of  discussion  in  recent  years  concern- 
ing school  buildings,  many  of  them  remain  altogether  unfit  places  in 
which  to  imprison  children  five  hours  a  day.  .  There  should  be  a 
thorough  physical  examination  of  every  child  entering  school,  and  at 
stated  intervals  thereafter.  In  one  high  school  in  this  city  two  boys  with 
herniae  were  recently  taken  from  a  gymnasium  class  by  a  watchful  prin- 
cipal, and  one  girl  in  the  same  school  became  livid  while  waving  dumb- 
bell's over  her  head  and  was  discovered  later  to  have  a  valvular  lesion 
of  the  heart.  No  doubt  these  illustrations  could  be  duplicated  by  the 
majority  of  physicians  in  the  city.  In  the  figures  quoted  above,  it  is 
quite  likely  that  very  few  if  any  of  the  parents  of  the  39  children  with 
adenoids  were  aware  of  this  condition.  Why  should  the  state  not  pro- 
vide for  the  medical  examination  of  pupils  as  well  as  for  their  intellectual 
examination  ? 

It  has  been  objected  that  this  savors  of  paternalism  in  government 
and  that  parents  will  themselves  look  after  the  health  of  their  children. 
The  fact  remains,  however,  that  they  do  not,  and  to  oblige  parents  to 
send  a  child  to  school  for  mental  training  and  pay  no  attention  to  a 
physical  infirmity  which  prevents  him  from  utilizing  the  opportunities 
provided  for  him  is  rank  inconsistency  and  resembles  offering  meat  t(5 
a  muzzled  dog. 

It  behooves  physicians  to  be  awake  in  these  matters.  The  public, 
?s  Dr.  Osier  so  aptly  expressed  it  a  few  days  ago,  "are  waking  up' and 
sittitng  on  the  edge  of  the  bed,"  in  medical  matters,  and  they  are  going 
to  hold  the  medical  profession  responsible  for  insisting  on  reforms,  the 
need  of  which  is  made  evident  by  our  professional  knowledge  and 
^raining. 

*  Dundee  Social  Union.    Report  of  Investigation  into  Social  Conditions  in  Dundee;  Part 
1.     Medical  Inspection  of  School  Children.    J.  Long  &  Co.,  Bank  Street,  Dundee,  iSOEj-..  ; 


166  DETROIT     MEDICAL    JOURNAL 

Nothnagel  and  Miculicz. 

The  last  few  weeks  saw  the  death  of  two  European  medical  pro- 
fessors, both  of  whom  have  been  for  many  years  particularly  well- 
known  on  this  side  of  the  Atlantic.  Professor  Herman  Nothnagel,  "Vor- 
stand"  of  the  first  medical  clinic  in  the  General  Hospital  of  Vienna,  died 
in  that  city  on  July  7th.  He  was  born  in  Germany  in  1841  grad- 
uating from  the  Medical  School  in  Berlin  in  1864,  and  became  a 
teacher,  serving  in  Konigsberg,  Breslau  and  Jena.  In  1882  he  was  ap- 
pointed professor  of  Clinical  Medicine  in  the  University  of  Vienna  and 
took  the  hospital  position  which  he  held  at  the  time  of  his  death.  From 
this  great  vantage  point  of  clinical  medicine,  his  fame  spread  rapidly 
throughout  the  whole  medical  world.  He  was  undoubtedly  one  of  the 
most  erudite  medical  men  of  this  generation.  While  not  a  few  clinicians 
have  been  his  superiors  in  bedside  diagnosis,  few  if  any  were  his  equal 
in  general  information  on  the  subject  of  internal  medicine.  He  was  a 
great  medical  writer  bringing  together  in  his  published  works  gleanings 
from  an  enormous  field  of  reading.  He  had  himself  superintended  a 
large  amount  of  research  work,  particularly  in  the  physiology  and  path- 
ology of  the  intestines.  His  death  will  be  mourned  by  a  wide  circle  of 
friends  in  this  country. 

In  the  death  of  Professor  von  Miculicz,  of  Breslau,  on  June  17th, 
surgery  suffers  a  distinct  loss.  He  first  became  known  when  still  an  as- 
sistant of  Billroth,  and  since  then  his  contributions  to  surgery  have  been 
both  numerous  and  important.  There  is  scarcely  a  field  which  has  not 
been  enriched  by  his  thought  and  work,  his  name  being  associated  with 
many  operations  and  devices.  More  recently,  the  work  on  enhancing 
the  resistance  of  the  peritoneum  before  operations  and  on  the  use  of  the 
pneumatic  cabinet  for  chest  operations  has  received  much  attention. 

Born  in  Austria  55  years  ago,  he  was  trained  under  Billroth  and 
held  the  chairs  in  surgery  successively  in  Cracow,  Konigsberg  and  Bres- 
lau, going  to  the  latter  clinic  in  1890.  He  was  also  known  as  an  editor  of 
marked  ability  and  was  ever  a  true  friend  of  the  American  student.  His 
visit  to  this  country  two  years  ago,  will  be  remembered  by  many. 


Diabetes  Insipidus. 

In  connection  with  the  paper  under  the  above  title  in  this  number 
of  the  Journal  it  is  important  to  keep  in  mind  that  an  hereditary  form 
of  this  disease  exists.  A  good  illustration  is  furnished  by  the  recent  ex- 
hibition by  Knopf elmacher  in  Vienna*  of  a  brother  (aged  12),  and  sister 
(aged  8),  who  had  suffered  from  earliest  childhood  with  this  disease. 
The  father,  grandfather,  and  paternal  great-grandmother  had  been  simi- 
larly affected.  Out  of  twenty  members  of  the  family  in  the  four  genera- 
tions, five  had  the  disease.  Both  children  were  thin.  The  boy  had  a 
cystitis  and  the  girl  ichthyosis  congenita,  but  no  other  abnormalities  were 
shown  except  that  each  had  an  enormously  distended  bladder.  The  boy 
passed  from  7  to  9  litres  of  urine  per  day  and  the  girl  5  to  6.3  litres. 

Knopfelmacher  believes  therapeutic  measures  to  be  of  no  avail  so 
far  as  the  fundemental  condition  is  concerned  in  these  congenital  cases. 

•Monotschrlft  Kinderh,  April,  1905. 


THERAPEUTIC    NOTES  167 

A  New  Journal. 

The  Journal  extends  good  wishes  to  The  American  Journal  of  Tu- 
berculosis, the  initial  number  of  which  has  just  reached  us.  Dr.  E.  L. 
Shurly,  the  well-known  author  and  throat  .and  chest  specialist,  is  editor, 
and  it  is  published  in  Detroit.  Every  factor  in  the  fight  against  tu- 
berculosis is  welcome,  and  this  new  periodical  promises  to  fill  a  place  of 
ereat  usefulness. 


THERAPEUTIC   NOTES 

Convulsions  in  Children. 

B  Chloral  hydratis,  gr.  v. 

Lactls,  3j, 
M.     Sig.:    As  a  rectal  injection. 
IJ  Sodii  Bromidi, 

Chloral  hydratis, 

Sodii  bicarb.,  of  each,  gr.  viij. 

Aquae,  fgj. 
Teaspoonful  every  hour,  to  a  child  under  four  months  old.     (Southern  Prac- 
titioner.) 

For  Acute  Bronchitis. 
IJ  Vini  ipecac, 

Tinct.  scillae,  of  each,  mx. 
Spts.  ether  nit.  $ss. 
Aq.  chloroform,  3ij. 
M.  Sig.:    At  one  dose  and  repeat  every  four  hours.     (Canadian  Practitioner 
and  Review). 

Migraine. 

The  following  prescriptions  are  suggested  for  migraine  by  Bjorkmann  (Merck's 
Archives) : — \ 

IJ  Caffeinae,  4  grains, 

Sodii  salicyl.,  8  grains. 

Cocaini  hydrochl.,  1-3  grain. 

Aquae,  1  ounce.' 

Syrupi  simpl,.  2^   drachms. 
To  be  taken  at  once.      Especially  active  where  trigeminal  neuralgia  accom- 
panies the  migraine. 

For  the  distressing  nausea  and  vomiting. — 
IJ  Tr.  zingiberis,  1  drachm. 

Tr.  capsici,  36  drops. 

Syrupi  zingerberis,  %  ounce. 

Aq.  menth.  pip.,  ad  3  ounces. 
Dessertspoonful  every  hour.       (Therapeutic  Review). 

Expectorant  for  Children  and  Adults. 

B     Potassium    iodid    

Camphorated  opium  tinct.  aa 5  J  ^ 

Ammon.   acetate   sol 5  ^s  2 

Tolu  syrup   5  vi  20 

Water,  p.  s ad ^  jv  120 

M.  Sig. :  One-half  to  one  teaspoonful  three  to  four  times  a  day. — Selected. 

Hay  Fever. 

IJ     Hyoscyamus  ext gr.  xij 

Potassium  iodid 5  J  ^ 

Potassium  bicarb   3  ij  ^ 

Licorice  ext.,  pur  ^iv  15 

Anise  water   ^  jvss  135 

M.  Sig. :  Dessertspoonful  every  four  hours  until  relieved. — ^Weber. 


168  DETROIT    MEDICAL    JOURNAL 

EDITORIAL   N0TE5 

Dr.  J.  B.Haynes  is  the  newly  appointed  health  officer  of  Dundee. 

Dr.  Clarence  W.  Harrison,  of  Allen,  Mich.,  has  located  in  Hillsdale. 

N.  B.  Sherman,  of  Marshall,  has  located  in  Battle  Creek  to  practice  medicine. 

Missouri  has  appropriated  $50,000  for  the  establishment  of  a  tuberculosis  hos- 
pital. 

Dr.  R.  B.  Hoag,  late  of  Fowlerville,  has  located  and  will  practice  in  Wayne, 
Mich. 

Dr.  S.  S.  Hanson  has  been  appointed  pension  examining  surgeon  at  Port 
Huron. 

Dr.  A.  L.  Finch,  of  1133  Russell  St.,  has  moved  to  the  corner  of  Beaubien  and 
High  Sts. 

Dr.  G.  E.  Ehle,  formerly  of  Grand  Rapids,  has  located  in  Butternut  with  office 
at  the  Hotel. 

Dr.  John  D.  Stewart,  of  Detroit,  has  located  in  Hartford  for  the  practice  of 
his  profession. 

Dr.  J.  Vernon  White  has  removed  his  offices  from  623-5  Majestic  Bldg.,  to  57 
Fort  street  west. 

Dr.  T.  E.  Sands  and  bride,  of  Battle  Creek,  have  returned  from  their  Euro- 
pean wedding  tour. 

Dr.  Sturgeon  has  been  placed  at  the  head  of  Hackley  hospital  of  Muskegon, 
succeeding  Dr.  Kelsey. 

Dr.  Johnson  of  Midland,  left  Monday  for  Chicago,  to  take  a  couple  of  months' 
special  course  in  surgery. 

Dr.  C.  W.  Merkel,  of  Charlotte,  Mich.,  a  graduate  of  the  U.  of  M.  of  this  year, 
has  located  at  Augusta,  111. 

The  Association  of  Military  Surgeons  of  the  United  States  convenes  in  De-» 
troit  September  26,  27  and  28. 

Dr.  Frank  Billings,  of  Chicago,  was  chosen  president  of  the  Association  of 
American  Physicians  on  May  17th. 

Boston  will  build  a  second  relief  station  in  connection  with  its  City  Hospital. 
The  new  one  will  be  located  in  East  Boston. 

Dr.  Rush  McNair,  of  Kalamazoo,  addressed  the  Allegan  Count  Medical  Socie- 
ty on  May  19th,  on  "Some  Varieties  of  Fractures." 

The  Massachusetts  legislature  has  passed  a  bill  appropriating  $150,000  for 
the  establishment  of  a  State  Hospital  for  Consumptives. 

Dr.  Clarence  Traphagen  left  Fenton  on  the  13th  ult.  from  New  New  York,  for 
study  in  London  hospitals.    He  will  be  gone  until  September. 

Dr.  T.  J.  Henry,  of  Twenty-third  street  and  Michigan  avenue,  has  returned 
after  a  month's  course  in  the  New  York  Post-Graduate  Hospital. 

A  Pharmacal  Department  is  to  be  established  in  connection  with  the  Michigan 
College  of  Medicine  and  Surgery,  which  is  about  to  go  into  new  quarters. 

Professor  Von  Noorden,  chief  physician  of  the  city  hospitals  of  Frankfort. 
Germany,  will  lecture  at  the  University  of  the  City  of  New  York  in  October. 

Dr.  Richard  C.  Cabot,  of  Boston,  has  been  elected  president  of  a  newly  organ- 
ized society,  to  be  known  as  the  New  England  Society  for  the  Education  of  the 
Nurse. 

Dr.  Phil  Sanderson  has  resigned  his  position  as  Wayne  County  Physician  and 
has  been  succeeded  by  Dr.  E.  B.  Forbes.  Dr.  Polozker  was  re-elected  as  his  col- 
league. 


EDITORIAL    NOTES  "  169 

FOR  SALE:  Physician's  practice  of  $1,500  or  $1,800  per  year;  one-acre  lot 
with  house,  barn  and  office;  oiRce  furniture  and  drugs,  $1,000  cash  will  buy 
this.  No  bonus  for  introduction.  Good  reason  for  selling,  and  further  information 
given  by  addressing  M.  H.  C.  Care  of  Detroit  Medical  Journal. 

PRACTICE  FOR  SALE:  Dr.  M.  N.  Coan,  New  Boston,  Mich.  Property  and 
practice,  five  years  village  and  county,  $1,500  to  $2,000.    Address  the  Journal. 


Dr.  Wadsworth  Warren,  Detroit,  is  the  editor  of  a  new  yachting  magazine 
called  Fore'n  Aft,  published  in  Chicago.  The  first  number  is  extremely  interesting 
and  attractive. 

Dr.  W.  A.  Chapman  has  recently  located  at  Ludington,  from  Portland,  Ore. 
He  is  a  graduate  of  the  University  of  Michigan  and  a  post  graduate  of  the  Ohio 
Wesleyan  College. 

Mrs.  William  Vanderhide,  wife  of  a  farmer  living  near  Muskegon,  gave  birth 
to  quadruplets  this  week.  The  babies  are  all  doing  well,  but  the  mother  died  soon 
after  they  were  born. 

Dr.  J.  A.  McMillan  and  family  have  rented  a  cottage  for  the  summer  at 
Macatawa  Beach.  The  doctor  will  spend  some  time  in  Chicago,  and  will  return 
to  Detroit  in  the  fall. 

Dr.  Margaret  E.  Otis  was  recently  appointed  house  physician  at  Emergency 
hospital  Monday  to  succeed  Dr.  Millie  E.  Wilson  who  returned  to  Rochester,  Mich., 
to  take  up  practice  with  her  father. 

Dr.  Joseph  A.  Belanger,  health  officer  of  River  Rouge,  is  at  Solvay  Hospital  in 
a  critical  condition,  from  septic  poisoning,  contracted  while  operating  on  a  pa- 
tient, from  a  small  cut  on  his  thumb. 

A  meeting  of  the  Saginaw  County  Medical  Society  occurred  on  May  9th.    Dr. 

E.  B.  Smith,  of  this  city,  read  a  paper  on  "Intestinal  Obstruction,"  and  Dr.  A.  L. 
Bailey,  of  Chesaning,  read  one  on  "Gall  Stones." 

At  a  meeting  of  the  Ohio  Medical  Association  officers,  at  Columbus,  arrange- 
ments were  completed  for  the  publication  of  the  society's  new  monthly  journal. 
It  will  be  called  the  Ohio  State  Medical  Journal. 

Dr.  Thomas  Opie,  for  33  years  dean  of  College  of  Physicians  and  Surgeons  of 
Baltimore  and  Professor  of  Gynecology  of  the  Faculty,  has  resigned.     Dr.  Chas. 

F.  Bevan,  Profossor  of  Surgery,  has  been  elected  dean. 

The  Health  Officers  of  both  Port  Huron  and  Saginaw  have  recently  had  seri- 
ous difficulties,  caused  by  the  failure  of  physicians  to  report  contagious  diseases. 
Prosecutions  were  threatened,  but  have  not  yet  been  carried  out. 

The  newly  appointed  city  physicians  of  Detroit  are  as  follows:  Dr.  Howard  B. 
Baker,  Dr.  Fred  E.  Thompson,  Dr.  Edmund  Quandt,  city  physicians;  Dr.  John  W. 
Hoffman,  city  pharmacist;  Dr.  J.  C.  Rutledge,  county  physician. 

Dr.  G.  C.  Chene,  of  Windsor,  and  Dr.  G.  W.  Robinson,  of  Scarboro,  Ont.,  have 
been  appointed  to  take  the  place  of  Dr.  Wm.  J.  Seymour  and  Dr.  L.  L.  Zimmer, 
whose  terms  have  expired  on  the  house  staff  at  St.  Mary's  Hospital. 

Dr.  W.  T.  Parker,  of  Fowlerville,  has  sold  his  practice  to  Dr.  J.  A.  McGarvah 
and  sailed  for  Germany.  Dr.  McGarvah  comes  from  Windsor,  Ont.,  and  is  a  grad- 
uate of  Detroit  College  of  Medicine,  spending  one  year  at  Harper  Hospital. 

Dr.  Irving  E.  Saunders,  of  Detroit,  formerly  of  Jackson,  has  been  arrested  for 
alleged  defrauding  a  widow  at  Tecumseh  to  the  amount  of  $925.  It  is  learnea 
from  one  of  his  attorneys  that  he  will  not  be  able  to  secure  the  $500  bail  required. 

Milwaukee  has  had  a  typoid  fever  scourge,  about  150  cases  having  occurred 
there  during  the  month  of  May.  It  was  discovered  there  that  the  water  in  Lake 
Michigan  had  become  polluted  by  sewage,  and  this  was  undoubtedly  the  cause  of 
the  epidemic. 

Dr.  D.  A.  MacLachlan  was  on  May  13th  nominated  as  vice-president  of  Grace 
Hospital  medical  board,  to  succeed  Dr.  Arthur  E.  Gue.  This  will  be  the  only 
change  in  the  board,  and  will  be  acted  upon  by  the  board  of  trustees  at  its  annual 
meeting  in  June. 


170  DETROIT     MEDICAL    JOURNAL 

On  account  of  the  coming  departure  of  Dr.  W.  R.  Ballard,  for  the  purpose  of 
taking  a  post-graduate  course  in  Europe,  he  has  disposed  of  his  practice  to  Dr.  W. 
B.  Clark,  of  St.  Louis,  Mich.,  and  Dr.  Clark's  practice  will  be  acquired  by  Dr. 
James  W.  Campbell,  of  Sebewaing. 

Dr.  L.  Campbell,  of  Birmingham,  has  been  appointed  a  member  of  the  state 
board  of  medical  registration  by  Gov.  Warner  to  succeed  Henry  B.  Landon,  M.  D., 
of  Bay  City.  He  will  assume  his  duties  Oct.  1.  He  is  a  U.  of  M.  graduate  and  has 
been  in  continuous  practice  for  twenty-five  years. 

The  Oakland  County  Medical  Society  has  fixed  a  schedule  of  prices  for  post 
mortem  examinations.  This  schedule  has  been  mailed  to  all  the  practitioners  in 
the  county.  The  prices  named  are  not  at  all  exhorbitant,  and  it  would  certainly 
be  an  excellent  thing  if  it  should  be  adhered  to  strictly. 

The  sudden  and  serious  illness  of  a  dozen  students  and  professors  at  Alma 
college  immediately  following  a  college  dinner,  has  caused  physicians  to  investi- 
gate the  cause  of  so  remarkable  an  occurrence,  and  the  conclusion  has  been 
reached  that  that  the  ice  cream  may  have  been  polluted  with  the  deadly  germs. 

Miss  Ethel  Gertrude  Bowman  was  married  to  Dr.  James  William  McEwan, 
Wednesday  evening.  May  17th.  Dr.  McEwan  is  a  graduate  of  the  University  of 
Edinburgh,  since  which  he  has  been  attending  the  University  of  Michigan.  He 
will  spend  some  time  in  study  in  London  before  beginning  a  practice  in  Detroit. 

Dr.  E.  L.  Shurly,  of  Detroit,  was  elected  president  of  the  American  Climatologi- 
cal  association  at  the  recent  meeting  in  Detroit.  Dr.  Blackader,  of  Montreal,  was 
chosen  first  vice-president;  Dr.  Sewall,  of  Denver,  2nd  Vice-President  and  Dr.  Guy 
Hinsdale,  of  Hot  Springs,  Va.,  was  re-elected  secretary  and  treasurer.  The  1906 
convention  will  be  held  at  Atlantic  City. 

Dr.  Osier  sailed  for  England  on  May  19.  He  is  proving  his  capacity  at  epi- 
gram again.  He  told  the  Tuberculosis  Congress  that  education  regarding  tubercu- 
losis was  the  thing  to  strive  for.  The  public,  he  said,  was  awake,  but  sitting  on 
the  edge  of  the  bed  and  not  yet  dressed.  When  the  public  got  dressed,  much 
would  be  accomplished  toward  stamping  out  the  disease. 

It  is  announced  that  the  Memorial  Institute  for  Infectious  Disease,  of  Chicago, 
has  established  a  serum  division  as  a  branch  of  its  scientific  and  experimental 
work,  of  which  Professor  Edwin  O.  Jordan,  of  the  University  of  Chicago,  has  been 
placed  in  charge.  In  connection  with  this  work,  it  is  expected  that  a  limited 
amount  of  diphtheria  antitoxin  will  be  available  for  distribution. 

Dr.  Samuel  W.  Lambert,  Dean  of  the  Medical  School  of  Columbia  University, 
New  York,  was  given  the  honorary  Master  of  Arts  Degree  by  Yale  at  its  com- 
mencement in  June,  while  Dr.  Abraham  Jacobi  was  made  LL.  D.  On  the  same 
day  Dr.  Jas.  H.  Wright,  of  Boston,  was  given  an  honorary  Doctor  of  Science  de- 
gree by  Harvard,  which  also  honored  her  own  Professor  Fitz  with  an  LL.  D. 

At  a  meeting  of  Wayne  county  board  of  poor  commissioners,  Dr.  John  J.  Marker 
was  appointed  to  succeed  James  Gillespie,  for  the  past  twenty  years  superintend- 
ent of  the  poor  house.  Dr.  Marker  will  retain  his  present  position  as  superintend- 
ent of  the  Eloise  Asylum.  The  city  poor  commission  will  appoint  three  new  city 
physicians  to  succeed  Drs.  George  W.  Augustine,  J.  H.  Neary  and  M.  A.  Fech- 
heimer. 

The  State  of  Arkansas  has  recently  passed  a  new  law  revoking  the  license  of 
any  physician  found  guilty  of  habitual  indulgence  in  the  use  of  alcohol,  opium, 
cocaine  or  any  such  agent  to  such  an  extent  as  to  render  himself  incapable  of  ex- 
ercising that  degree  of  skill  and  judgment  which  the  moral  trust  and  confidence 
reposed  in  him  demands,  said  license  not  to  be  renewed  under  one  year,  and  not 
then  unless  satisfactory  evidence  is  produced  that  he  has  ceased  such  indulgence. 

Whether  correctly  or  not,  the  name  of  Dr.  H.  O.  Walker,  as  the  professor.  Is 
connected  with  this  incident:  A  bright  young  chap  appeared  at  clinics  with  the 
dregs  of  a  hilarious  night  still  working.  A  woman  was  presented  with  one  side 
of  her  lower  jaw  dislocated.  "How  would  you  reduce  the  dislocation?"  was  asked  of 
the  young  man.  "How  was  it  caused,  professor?"  sparring  for  wind.  "In  strapping 
a  very  tightly  packed  trunk."  "I  would  advise  th$  lady  to  unstrap  it  'immediate- 
ly." 

Port  Huron's  new  hospital  was  thrown  open  to  the  public  for  use  on  the  10th 
of  June.  The  building  is  three  stories  in  heighth,  built  of  Brick  and  will  accommo- 
date fifty  patients.  Mr.  Chas.  Baer  made  the  largest  donation,  givin  a  site  and 
$10,000  in  cash.    The  balance  of  the  money,  about  $20,000,  was  raised  in  an  ideal 


EDITORIAL    NOTES  171 

way,  practically  every  social  organization  in  the  city  assisting  in  raising  money 
for  the  purpose.  Dr.  M.  Wilson  is  president  of  the  Board  of  Trustees,  and  Dr.  T. 
L\  Heavenrich  is  a  member  of  the  Board. 

Dr.  Samuel  KItcher,  president  of  Saginaw's  board  of  health,  is  determined  that 
the  physicians  shall  live  up  to  the  requirements  of  the  state  law,  as  to  contagious 
diseases.  At  a  meeting  of  the  local  board  it  was  reported  that  a  smallpox  patient 
had  been  sent  to  the  detention  hospital,  but  that  the  case  had  not  been  reported 
to  the  health  officer,  as  required  by  law.  President  Kitchen  wanted  a  warrant 
issued  for  the  delinquent,  but  as  this  could  not  be  done,  the  case  being  a  civil  and 
not  a  criminal  one,  he  will  have  the  matter  brought  to  the  attention  of  the  prose- 
cuting attorney. 

In  the  City  of  Mexico  a  splendid  hospital  has  just  been  completed,  at  a  cost 
ot  $3,000,000.  It  is  considered  to  be  the  finest  in  the  world,  built  on  the  pavillion 
plan,  having  47  pavillions.  There  are  special  pavillions  for  hydrotherapy,  electro- 
therapy and  mechano-therapy.  with  trained  men  in  charge  of  each  department. 
Segregation  of  the  infectious  diseases  is  accomplished  by  seven  buildings,  sepa- 
rated from  the  remaining  buildings  by  an  eight-foot  wall.  Pneumonia  and  phthisis 
are  classed  among  the  infectious  diseases  and  there  is  a  separate  building  for 
each,  with  other  buildings  for  yellow  fever,  smallpox,  etc. 


MARRIAGES. 


Dr.  Roy  O.  Woodruff,  of  Bay  City,  was  married  to  Miss  Veray  M.  Hall,  of  the 
same  city. 

Dr.  Frank  B.  Walker  and  Miss  Kate  H.  Jacobs,  both  of  Detroit,  were  married 
on  June  26th. 

Dr.  Ralph  Apted,  of  Grand  Rapids,  was  married  to  Miss  Susan  Fisher  of  that 
city  on  June  16th. 

Dr.  W.  S.  Shipp,  of  Battle  Creek,  was  married  on  June  28th  to  Miss  Florence 
Temple,  of  Tecumseh. 

Dr.  G.  H.  Lynch,  of  Traverse  City,  was  married  on  June  21st  to  Miss  Una 
Palmer,  of  Big  Rapids. 

Dr.  Wm.  F.  Acker,  of  Monroe,  was  married  on  June  7th  to  Miss  Mildred  H. 
Crane,  a  Harper  Hospital  nurse. 

Miss  Mabel  Drews,  daughter  of  Mrs.  Gus  W.  Edson,  of  75  Brady  street,  this 
city,  was  married  on  June  20.  to  Dr.  Jay  F.  Pool. 

The  marriage  of  Miss  Otille  Fude  to  Dr.  Charles  Freiberg  took  place  at  the 
family  residence  on  Lincoln  avenue,  on  May  3rd. 

Dr.  John  S.  Hall,  of  Delray,  and  Miss  Emily  Fettig,  of  the  same  place,  were 
married  on  June  14th.     The  doctor  will  continue  his  practice  at  Delray. 

The  marrirage  of  Miss  Madeleine  Nouyaut,  of  Toledo,  0.,  and  Dr.  Charles 
F,  Pequegnot,  of  this  city,  took  place  June  15,  at  the  home  of  the  bride. 

The  marriage  of  Miss  Mary  Mickleborough  to  Dr.  F.  Reno  Deming,  Detroit,  was 
solemnized  Wednesday  evening,  May  17,  at  the  residence  of  the  bride's  mother,  Mrs. 
L.  M.  Mickleborough. 

Dr.  Leia  Nell  French,  of  Benton  Harbor,  and  Prof.  Carl  G.  McClellan,  of  Jef- 
ferson, O.,  were  married  by  the  Rev.  W.  P.  French,  father  of  the  bride,  at  Benton 
Harbor,  Mich.,  June  7. 

Three  Adrian  physicians  have  recently  joined  the  matrimonial  order  of  Ben- 
edicts. Dr.  Ransom  A.  Race  to  Miss  Howes;  Dr.  H.  A.  Wright  to  Miss  Florence 
Clements  and  Dr.  Guy  M.  Claflin  to  Miss  Anna  Owens. 


DEATHS. 


Chas.  A.  Wean,  D.  M.  C,  1885,  died  on  May  28  in  Chicago.  Deceased  was 
fort  yyears  of  age  and  died  of  Septicaemia. 

Dr.  William  Lushington,  of  Toledo,  who  fell  at  the  corner  of  Congress  and 
Griswold  streets,  fracturing  his  skull,  died  at  Emergency  Hospital  on  May  5. 

Dr.  James  Sleet,  aged  82,  of  Byron,  is  dead.  He  was  assistant  surgeon  of  the 
Sixth  Michigan  cavalry  during  the  rebellion,  served  with  Custer  in  Wyoming,  and 
was  a  member  of  the  Shiawassee  bar  since  the  war. 


372  DETROIT     MEDICAL     JOURNAL 

Association   of   Military  Surgeons. 

The  Annual  Meeting  of  this  organization  will  be  held  in  Detroit  September 
26-27-28  next.  The  scientific  sessions  will  be  held  at  the  Hotel  Cadillac  from  9-12 
a.  m.  and  1.30  to  4  p.  m.  of  each  day.  Major  Henkel,  who  is  in 
charge  of  the  local  arrangements,  has  prepared  a  most  attractive  program 
of  social  events  for  the  members  and  their  wives,  including  a  reception 
at  the  Cadillac,  a  tally-ho  ride,  supper  at  the  Detroit  Yacht  Club,  reception  at  De- 
troit Art  Museum,  a  theatre  party  and  special  trips  to  Orchard  Lake  and  the  Flats. 
Surgeon-General  Wyman,  of  Washington,  will  preside  at  the  scientific  meetings. 
The  program,  which  will  appear  in  our  next  issue,  will  include  some  personal  ob- 
servations on  the  medical  service  of  the  Russo-Japanese  War  which  will  undoubt- 
edly be  of  great  interest.  The  medical  profession  at  large  is  cordially  invited  to  at- 
tend the  scientific  sessions. 


New  Appointment. 

Dr.  A.  P.  Ohimacher,  recently  of  Gallipolis,  Ohio,  has  been  appointed  director 
of  the  biologic  laboratories  of  Frederick  Stearns  &  Co.,  of  Detroit,  and  has  entered 
upon  the  duties  of  that  position,  which  are  chiefly  those  of  original  research  in 
biologic  therapeutics. 

Medical  men  familiar  with  the  literature  of  pathology,  bacteriology  and  serum 
therapy  in  America,  know  Dr.  Ohimacher  as  a  pioneer  investigator  in  these 
branches  of  science.  He  was  one  of  the  first  bacteriologists  in  this  country  to 
immunize  a  horse  against  diphtheria,  and  to  produce  a  serum  of  clinical  value. 
His  work  attracted  widespread  attention,  and  it  is  significant  that  his  papers 
published  in  1904  on  the  preparation,  uses  and  value  of  antidiphtheric  serum  still 
stand  as  authoritative  utterances  on  the  subject.  This  work  was  purely  scientific, 
carried  out  on  an  extensive  experimental  scale,  both  in  the  laboratory  and  at  the 
bedside,  and  antedated  the  commercial  production  of  antitoxin  in  America.  As 
a  teacher  and  author  Dr.  Ohimacher  is  equally  well  known  to  the  profession,  and 
the  fact  that  he  is  to  have  entire  charge  of  the  important  biologic  interests  of  the 
Searns  house  gives  additional  assurance — if  any  were  needed — of  the  liberal  atti- 
tude of  that  institution  towards  the  scientific  work,  which  is  the  pride  and  glory 
of  American  medicine. 


International   Medical  Congress. 

The  next  International  Medical  Congress  will  be  held  in  Lisbon,  April  10  to 
26,  1906.  It  is  expected  that  it  will  be  one  of  unusual  importance,  for  a  meeting 
which  will  be  held  in  what  has  always  been  considered  as  an  out  of  the  way  coun- 
try. Already  the  titles  of  papers  from  some  of  the  most  distinguished  men  of  the 
medical  profession  have  been  received.  Some  of  the  topics  for  discussion  that 
have  been  selected  by  the  Executive  Committee  are  the  following: 
Section  of  Descriptive  and  Comparative  Anatomy,  Anthropology,  Embryology  and 
Histology. 

Definition,  structure  and  composition  of  protoplasm. 

Origin,  nature  and  classification  of  pigments. 

Cellular  changes  in  normal  tissues. 

Evolution  and  involution  of  the  thymus  gland. 
Section  of  Physiology. 

The  role  of  leucocytes  in  nutrition. 

The  thyroid  secretion. 

Renal  permeability. 

The  nutritive  value  of  alcohol. 

The  physiology  of  the  cytotoxins. 

The  blood  ferments. 
Section  of  General  Pathology,  Bacteriology  and  Pathological  Anatomy. 

What  are  the  present  scientific  proofs  of  the  parastic  nature  of  neoplasms, 
especially  of  cancer? 

Preventive  inoculations  against  bacterial  diseases. 

Preventive  inoculations  against  protozoic  diseases. 

Preventive  inoculations  against  diseases  from  an  unknown  specific  agent. 

The  pancreas  and  fat  necrosis. 
Therapeutics  and  Pharmacology. 

Local  therapeutics  in  infectious  diseases. 


EDITORIAL    NOTES  17?' 

Separation,  from  a  physiological  and  therapeutic  point  of  view,  of  the  different 
radiations  produced  in  Crooke's  tubes  and  of  those  which  are  sent 
out  by  radioactive  bodies. 

The  therapeutic  value  of  bactericidal  serums. 

The  relation  between  the  molecular  constitution  of  organic  bodies  and  their 
physiological  and  therapeutic  action. 
Section  of  Medicine. 

The  pathogenesis  of  diabetes. 

The  pathogenesis  of  arterial  hypertension. 

The  treatment  of  cirrhosis  of  the  liver. 

Cerebrospinal  meningitis. 

International  defense  against  tuberculosis. 

Meningeal  hemorrhages. 
Section  of  Pediatrics. 

Spastic  affections  of  infancy;  classification  and  pathogenesis. 

Cerebrospinal  meningitis;   etiology  and  treatment. 

The  social  struggle  against  rickets. 

Orthopedic  surgery  in  affections  of  nervous  origin,  spastic  and  paralytic. 

Congenital  dislocation  of  the  hip. 

The  treatment  of  abdominal  tuberculosis  (peritoneal). 
Neurology,  Psychiatry  and  Criminal  Anthropology. 

Penal  reform  from  the  anthropologic  and  psychiatric  point  of  view. 

Forms  and  pathogenesis  of  dementia  praecox. 

The  relations  of  progressive  muscular  atrophy  to  Charcot's  disease. 

Cerebral  localization  in  mental  disease. 

Education  and  crime. 

Stigmata  of  degeneration  and  crime. 
Section  of  Surgery. 

Septic  peritoneal  infections;   classification  and  treatment. 

Gastrointestinal  and  intestinointestinal  anastomoses. 

Recent  additions  to  arterial  and  venous  surgery. 
Section  of  Medicine  and  Surgery  of  the  Urinary  Organs. 

Surgical  intervention  in  Bright's  disease. 

Surgical  treatment  of  prostato-vesical  tuberculosis. 

Progress  of  urology  in  the  diagnosis  of  renal  disease. 

Painful  cystides. 
Section  of  Opthalmology. 

Blepharoplasty. 

Serotherapy  in  ophthalmology. 
Section  of  Laryngology,  Rhinology,  Otology  and  Stomatology. 

Study  of  the  epileptogenous  action  of  foreign  bodies  in  the  ear  and  of  vegeta- 
tions in  the  naso-pharynx. 

The  different  forms  of  suppuration  of  the  maxillary  sinus. 

Injections  of  paraffin  in  rhinology. 

Differential  diagnosis  of  tubercular,  syphilitic  and  cancerous  lesions  of  the 
larynx. 

Choice  of  anesthesia  in  the  extraction  of  tooth. 

Treatment  of  alveolar  suppuration. 
Section  of  Obstetrics  and  Gynecology. 

Conservative  surgery  of  the  ovaries. 

Tuberculosis  of  the  adnexa. 

Symphisiotomy. 

Pregnancy  and  cancer  of  the  uterus. 

Therapy  of  puerperal  infections. 
Section  of  Hygiene  and  Epidemiology. 

The  intermediary  of  yellow  fever. 

The  co-operation  of  nations  to  prevent  the  importation  of  yellow  fever  and 
the  pest. 

Watering  the  streets  as  a  means  against  tuberculosis. 

Recent  additions  to  the  etiology  and  epidemiology  of  epidemic  cerebrospinal 
meningitis. 
Section  of  Military  Medicine. 

Portable  ration  of  the  soldier  during  campaign. 

The  purifying  of  the  country. 

Emergency  hospital  on  the  battlefield. 


174  DETROIT     MEDICAL    JOURNAL 

Section  of  Legal  Medicine. 

Signs  of  death  from  drowning. 

Ecchymoses  in  legal  medicine. 

Epilepsy  in  legal  medicine. 

Organization  of  medico-legal  services. 
Section  of  Colonial  and  Naval  Medicine. 

Etiology  and  prophylaxis  of  beri-beri. 

Etiology  and  prophylaxis  of  dysentery  in  hot  countries. 

Mental  diseases  in  tropical  countries. 

Hospital  ships  and  their  function  in  time  of  war. 

Tuberculosis  in  the  navy  and  its  prophylaxis. 


PROGRESS  OF  MEDICAL  SCIENCE 

Some  Cases  of  Uveitis  Due  to  Accessory  Sinus  Disease. 

H.  H.  Fish,  M.  D.  (The  American  Journal  of  Ophthalmology,  Dec,  1904),  writes 
an  instructive  and  entertaining  article  upon  this  subject  which  is  more  or  less  new 
in  the  views  advanced  as  to  the  causation  of  deep  seated  inflammatory  disease  of 
retina,  choroid  and  optic  nerve. 

Fish  goes  into  the  anatomic  connection  between  the  venous  supply  of  the 
uveal  tract  and  the  accessory  sinus  of  the  nose  and  upon  this  connection  bases 
liis  view  of  etiologic  relationship  between  sinusitis  and  the  ocular  lesions. 

He  quotes  copiously  from  ophthalmic  literature  and  presents  six  cases  in 
which  the  ocular  pathologic  manifestations  were  markedly  improved  by  probing 
and  syringing  the  fronto-nasal  canal  in  those  cases  presenting  tenderness  over 
the  frontal  sinus. 

In  conclusion.  Fish  notes  that  in  these  six  cases  the  following  points  are  made: 

l§t.  A  negative  history  in  all  these  patients  of  all  constitutional  causes  of  the 
ocular  lesions. 

2nd.  In  all  the  presence  of  a  sinusitis. 

3rd.  In  all  a  partial  paresis  of  the  pupil  and  accommodation. 

4th.  The  rarity  of  the  detection  of  the  relationship  between  these  conditions 
is  due  to  the  fact  that  the  symptoms  of  latent  or  closed  stinusitis  is  manifested 
about  the  eye,  hence  the  rhinologist  does  not  see  and  diagnose  these  cases. 


Dr.  Osier's  Farewell  Address. 

"Unity,  Peace  and  Concord"  is  the  title  chosen  for  his  address  by  Dr.  Osier 
(Journal  A.  M.  A.,  August  5).  The  medical  profession  is  the  only  one,  he  says,  that 
everywhere  throughout  the  world  has  the  same  methods,  ambitions  and  aims — 
It  is  the  only  world-wide  profession.  In  a  little  more  than  a  century  a  united  pro- 
fession working  in  every  land  has  done  more  for  the  race  than  any  other  body  of 
men.  Any  great  discovery  in  any  part  of  the  world  is  common  property  at  once. 
In  referring  to  the  things  needed  to  bring  about  perfect  unity  in  the  profession  in 
this  country,  he  laid  special  emphasis  on  the  need  of  reciprocity  in  the  medical 
practice  laws  in  the  various  states  and  territories,  and  the  need  for  consolidation 
of  medical  schools  and  for  the  recognition  of  those  homeopathic  physicians  who  are 
ready  to  accept  the  facts  of  scientific  medicine.  Osier  believes  that  mutual  con- 
cessions only  are  needed,  such  as  the  abandonment  of  special  designation,  and  the 
intelligent  toleration  of  therapeutic  vagaries  that  have  always  beset  the  profession, 
but  are  at  worst  only  flies  on  the  wheels  of  progress.  He  advocates  peace,  but  by 
this  he  does  not  mean  cessation  of  our  professional  conflict  with  ignorance,  apathy 
and  vice.  This  must  be  steadily  carried  on.  There  is,  however,  at  times,  he  says, 
a  lack  of  the  professional  harmony  that  should  exist,  and  this  is  to  be  lamented. 
He  thinks  that  there  are  three  chief  causes  of  the  quarrels  of  physicians.  The 
first  is  lack  of  proper  friendly  intercourse,  the  second  is  uhcharitableness,  and  the 
third  is  the  wagging  tongue  of  individuals,  who  are  too  often  ready  to  make 
trouble  between  physicians.  He  says  that  a  physician  should  never  listen  to  a 
patient  who  tells  tales  derogatory  of  other  physicians,  and  should  not  believe  them, 
even  if  he  thinks  they  may  be  true. 


PROGRESS    OF    MEDICAL    SCIENCE  175 

5th.  The  frightful  pain  accompanying  an  iritis  is  often  due  not  to  the  ocular 
lesion  but  to  the  accompanying  sinusitis. 

6th.  The  relationship  is  much  more  frequently  found  when  looked  for  than  the 
literature  on  the  subject  of  uveitis  would  leal  one  to  suppose. 

DON.  M.  CAMPBELL. 


Feeding  Hungry  School  Children. 

In  Brussels  every  school  child  is  medically  examined  once  every  ten  days. 
Its  eyes,  teeth,  ears,  and  general  physical  condition  are  overhauled.  If  it  looks 
weak  and  puny  they  give  it  doses  of  codliver  oil  or  some  suitable  tonic.  At  mid- 
day it  gets  a  substantial  meal,  thanks  to  private  benevolence  assisted  by  com- 
munal funds,  and  the  greatest  care  is  taken  to  see  that  no  child  goes  ill-shod,  ill- 
clad,  or  ill-fed. 


Splenomedullary  Leukemia. 

Drs.  Everett  J.  Brown  and  Cecil  M.  Jack,  Decatur,  111.,  reported  in  The  Journal 
A.  M.  A.  ,March  26,  1904,  a  case  of  splenomyelogenous  leukemia  symptomatically 
cured  by  X-ray  treatment.  In  The  Journal  A.  M.  A.,  March  25,  they  report  the  final 
outcome  of  the  case  with  autopsy  findings  In  the  fall  of  1904  the  patient  began 
to  become  weaker,  the  spleen  enlarged  again  and  he  finally  succumbed  with 
typhoid-like  symptoms  just  sixteen  months  after  first  coming  under  observation. 
The  macroscopic  examination  showed  a  somewhat  enlarged  spleen,  some  kidney 
lesions  and  no  special  gastrointestinal  abnormalities.  The  pathologic  examination 
showed  a  marked  fibrosis  of  the  spleen  with  a  general  picture  of  splenic  anemia, 
no  evidence  of  leukemia  in  the  intestines  or  lungs,  extensive  deposits  of  lime  salts 
in  the  kidneys  involving  especially  the  convoluted  tubules,  and  the  lymph  glands 
showed  a  lymphoid  hyperplasia  resembling  that  of  lymphatic  leukemic  disease. 
Dr.  A.  S.  Warthin,  of  Ann  Arbor,  who  made  the  pathologic  examination,  remarks 
that  the  only  conclusion  justified  by  the  findings  would  seem  to  be  that  the  X-ray 
treatment  had  resolved  the  leukemic  condition  into  an  aleukemic  state,  but  that 
the  essential  disease  process,  as  shown  by  the  lymph  glands,  was  still  active.  The 
leucocytes  have  been  removed  from  the  general  circulation  and  from  the  areas  of 
infiltration,  and  the  splenic  changes  seemed  to  be  secondary.  The  remarkable 
condition  in  the  kidneys  offers  room  for  some  speculation  as  to  the  source  of  a 
toxin  such  as  might  result  from  very  extensive  destruction  of  leucocytes.  No 
specimen  of  bone  marrow  was  secured,  which  the  authors  regret. 


Mortality,  Disability,  and  Permancy  of  Cure  in  Surgery. 

Under  the  above  title  Dr.  C.  H.  Mayo,  in  the  Northwestern  Lancet,  May  15, 

discusses  what  is  practically  the  patient's  point  of  view,  which  is  too  often  ignored 
by  the  surgeon.  If  death  occurs  in  the  hospital,  no  matter  how  long  after  an 
operation,  the  laynlan  connects  it  with  the  operation;  the  writer,  in  compiling 
mortality  rates  of  operations,  has  adopted  the  same  criterion. 

To  the  patient,  the  period  of  disability  is  often  all-important;  the  surgeon 
should  reduce  it  by  making  wounds  as  small  as  possible,  and  by  using  great  care 
in  the  drainage  of  wounds.  Dr.  Mayo  detains  hernia  cases  in  bed  only  13  days  in 
favorable  cases,  and  stomach  and  gall-bladder  cases  only  12  to  14  days.  He  seldom 
drains  through  the  operation  wound,  but  closes  it  tight  and  drains  by  separate 
puncture  wounds,  which  lessen  the  likelihood  of  hernia. 

Permancy  of  cure  can  be  fairly  well  predicted  except  in  malignancy,  and  even 
then  can  be  better  prognosticated  than  formerly,  by  our  advanced  knowledge  of 
the  lymphatic  system.  In  this  field  the  outcome  depends  upon  the  early  diagnosis 
and  prompt  recommendation  of  radical  removal. 

— C.  S.  OAKMAN. 


Carpal,  Scaphoid,  and  Semilunar. 

In  the  Annals  of  Surgery,  April  and  June,  Codman  and  Chase  discuss  at  length 
the  diagnosis  and  treatment  of  fracture  of  the  scaphoid  and  dislocation  of  the 
semilunar  bone,  based  upon  study  of  the  literature  and  the  observation  of  many 
cases  coming  under  their  notice. 

Simple  fracture  of  the  scaphoid  gives  localized  swelling  in  the  radical  half  of 
the  wrist,  acute  tenderness  in  the  anatomical  snuff-box  on  adduction  of  the  hand. 


176  DETROIT     MEDICAL     JOURNAL 

and  limitataion  of  extension;  X-ray  is  the  final  confirmation.  So-called  "sprains" 
of  the  wrist  which  fail  to  get  well  often  prove  to  be  fractured  scaphoids  or  dis- 
located semilunars,  or  both.  Such  fractures  show  very  little  power  of  repair  and 
give  trouble  for  years.  Treatment ^  by  immobilization,  if  not  successful  in  four 
weeks,  usually  is  not  curative  on  longer  trial;  these  cases  give  better  results  if 
the  proximal  fragment  is  excised,  followed  in  a  week  after  operation  by  passive 
motion. 

Anterior  dislocation  of  the  semilunar  produces  a  silver  fork  deformity,  with 
a  posterior  hollow  proximal  to  the  os  magnum  and  an  anterior  prominence  distal 
to  the  lower  end  of  the  radius;  a  shortened  palm;  stiffness,  and  pain  on  motion 
of  the  fingers.  Recent  dislocations  are  reducible,  but  old  ones  usually  require 
incision  of  the  bone. 

All  carpal  injuries  should  be  carefully  examined,  else  these  rarer,  but  well 
defined  conditions  will  not  be  diagnosed;  the  X-ray  should  be  employed  when 
possible,  but  in  interpreting  radiographs  it  must  be  remembered  that  bipartite 
fccaphoids  occur,  though  very  rarely.     Full  bibliography  is  appended. 

/  — C.    S.    OAKMAN. 


Foreign  Bodies  in  the  Eye. 

Peter  A.  Callan,  M.  D.,  (Medical  Review  of  Reviews,  April  25,  1905),  writes 
an  interesting  and  instructive  article  upon  the  above  subject. 

The  author  touches  upon  the  different  prognosis  as  to  recovery  and  retention  of 
jury  done  in  the  penetration  of  the  missile  and  also  in  the  manipulation  necessary 
for  its  removal;  (2nd)  the  position  at  which  the  foreign  body  comes  to  rest  within 
the  eye.  The  arterior  vitreous;  (3rd)  penetration  of  the  ciliary  body  adds  greatly 
to  the  gravity  of  prognosis. 

The  opinion  of  the  patient  as  to  the  presence  or  absence  of  a  retained  foreign 
body  is  very  untrustworthy.  Three  methods  for  arriving  at  a  diagnosis  as  to  the 
presence  of  a  foreign  body  in  an  eye  whose  media  are  too  cloudy  to  admit  of  seeing 
the  missile  with  the  ophthalmoscope,  are  employed  viz:  (1st)  The  x-ray  photo- 
graph; (2nd)  The  magnetic  needle  (the  astatic  needle  of  Gerard  and  the  sidero- 
scope  of  Asmus)  and,  (3rd)  the  Haah  giant  magnet. 

Conclusions: 

Never  take  the  patient's  word  as  to  the  presence  or  absence  of  a  foreign  body. 
All  foreign  bodies  should  be  removed.  A  foreign  body  in  the  vitreous  is  the  most 
dangerous.  Avoid  if  possible  a  scleral  incision.  When  there  is  a  traumatic  catar- 
act from  passage  of  foreign  body  through  the  lens,  the  cataract  should  be  removea 
and  magnet  introduced  through  the  pupillary  space.  The  foreign  body  should  be 
removed  with  as  little  traumatism  as  passible. — DON.  M.  CAMPBELL. 


Prostitution. 


Woods  Hutchinson,  M.  D.  (Medical  News).  The  vital  questions  of  the  problem 
are  two  in  number:  first,  what  class  and  character  of  men  and  women  are  affected 
by  this  institution?  and,  second,  in  what  are  they  affected?  First,  as  to  the  women, 
the  almost  unanimous  testimony  of  the  replies  received,  as  well  as  of  the  figures  of 
Du  Chalet  in  Paris,  (a)  that  90  per  cent,  of  prostitutes  are  drawn  from  the  lowest 
and  most  ignorant  class  of  the  population;  (b)  that  they  are  led  to  this  life  by  the 
desire  for  luxury,  display  and  idleness,  a  purely  trade-instinct,  in  fact,  and  not  by 
strong  sexual  impulses,  want,  or  seduction  and  desertion;  (c)  that  their  average 
life-time  after  entering  this  career  is  9.0  years;  (d)  that  during  this  period  they 
are  practically  sterile;  (e)  that  very  few  of  them  permanently  reform,  and  those 
who  do  are  extremely  infertile.  Now  as  to  the  men.  Unlike  the  women,  they  are 
drawn  from  no  single  class,  condition,  or  age  in  the  community,  but  from  all  alike. 
They  are  drawn  into  the  vortex  by  an  instinct,  it  is  true,  but  not  a  natural  one — 
a  perverted  one.  It  is  astonishing  how  little  "passion"  there  is  in  the  trade  on 
either  side.  So  far  from  the  "hot  blood  of  youth"  being  chiefiy  responsible,  houses 
of  ill-repute  derive  two-thirds  of  their  income  from  married  men  over  forty.  In 
fact,  the  essential  "Leit  motif"  of  the  practice  is  not  the  sexual  impulse  pure  and 
simple,  but  the  desire  to  indulge  that  impulse  and  escape  its  natural  and  legitimate 
consequences,  conception.  And  in  this  respect  women  are  just  as  much  to  blame 
as  men.  Many  a  man  is  driven  to  the  brothel  by  his  own  wife.  Three  sources 
chiefiy  feed  the  reeking  stream  of  prostitution,  two  of  which  are  best  characterized 
in  the  phrases,  "can't  afford  to  marry,"  and  "don't  want  to  be  bothered  with  chil- 


PROGRESS    OF    MEDICAL    SCIENCE  177 

dren,"  and  the  last  and  chiefest  is  limiting  unduly  the  size  of  families.  This  is  the 
civilized  successor  of  infanticide,  and,  like  it,  is  the  racial  "sin  against  the  Holy 
Ghost,  which  shall  not  be  forgiven." 

How  are  the  supporters  of  this  "institution"  affected  by  it?  The  general  im- 
pression is,  especially  in  respect  to  the  women,  that  they  are  rapidly  killed  by 
venereal  disease  and  sexual  excess,  but  upon  gathring  reliable  facts  we  find  the 
actual  mortality  from  either  of  these  causes  decidedly  low.  Brain  syphilis  and 
locomotor  ataxia  among  the  men,  and  gonorrheal  peritonitis  among  the  women, 
are  almost  the  only  actual  fatal  forms  of  venereal  disease,  and  when  we  come  to 
examine  the  "bogey"  of  "sexual  excess"  we  are  simply  astonished  to  find  how  few 
permanently  injurious  results  of  any  sort  are  produced  by  it.  What,  then,  does 
shorten  the  life  of  the  prostitute?  My  replies  were  absolutely  unanimous  upon  this 
point  and  surprised  me  greatly.  Every  observer  gives  alcohol  the  first  place,  mor- 
phine, chloral,  and  venereal  disease  come  almost  together  as  bad  seconds,  suicide 
is  fourth,  and  irregular  hours  and  exposure  next.  Thus  alcohol  is  found  here,  as 
elsewhere,  one  of  the  best  friends  of  civilization.  It  is  worth  all  the  police  systems 
and  "missions"  ever  invented  for  the  elimination  of  the  criminal. 

But  although  this  vice  has  so  comparatively  little  direct  effect  upon  the  life 
chances  of  its  patrons,  it  affects  them  all  with  great  force  and  certainty  in  another 
respect.  It  is  the  most  efficient  sterilizer.  The  prostitute;  of  course,  for  obvious 
reasons,  seldom  bears  children  during  her  "active"  life,  and  usually  becomes  sterile 
sooner  or  later  by  endometritis  or  salpingitis,  before  alcohol  or  premature  old  age 
claims  her.  She  seldom  "reforms"  (thank  heaven),  and  if  she  does,  bears  few 
children. 

Now  as  to  the  man.  Supposing  he  is  infected  with  syphilis,  what  results? 
Under  any  circumstances  or  any  treatment  he  is  absolutely  sterile  for  from  two  to 
seven  years,  either  by  abstinence  or  by  the  infection  of  whatever  woman  may  be 
unfortunate  enough  to  be  his  wife  during  that  time.  Abortion  after  abortion  occurs 
until  viable  children  are  born,  but  even  then !  Tarnier  declares  that  eighty- 
five  per  cent,  of  syphilitic  children  die  before  the  sixth  month.  As  to  gonorrhea, 
the  revolution  in  professional  opinion  in  this  regard  is  simply  startling.  No  longer 
regarded  as  a  mere  trifie,  its  effects  are  found  to  be  appallingly  widespread.  Or- 
chitis on  the  one  hand,  and  pyosalpinx  on  the  other,  spring  up  in  swarms  in  its 
wake  like  veritable  dragon's  brood.  The  despairing  cry  goes  up,  "It  is  doubtful 
whether  gonorrhea  is  ever  cured!"  Here,  again  "justice  may  move  with  a  leaden 
foot,  but  she  strikes  with  an  iron  hand."  That  insignificant  little  infection  gonor- 
rhea, "of  no  more  importance  than  a  cold  in  the  head,"  is  found  to  be  followed  by 
a  Nemesis  of  infirmity  which  is  simply  appaling. 

To  sum  up,  then  from  the  female  side  of  this  institution,  our  conclusion  would 
be  that  it  is  concerned  principally  with  the  most  worthless  variety  of  women,  the 
degenerate  or  criminals,  and  the  idle,  the  mercenary,  and  shameless  of  the  lower 
classes;  in  short,  women  whom  the  community  can  well  afford  to  spare;  that  these 
women,  when  fairly  in  its  grasp,  are  practically  prevented  from  propagating  their 
kind  during  their  career,  and  rapidly  destroyed  if  they  remain  in  it;  that  very  few 
marry,  and  those  who  do  are  barren  in  a  very  high  degree;  in  short,  it  is  an  elimin- 
ative  agency  of  high  value  and  wonderful  efficiency  for  first  rendering  sterile  and 
then  rapidly  destroying  the  worst  specimens  of  their  sex — women  whose  "reform" 
and  child-bearing  would  be  a  curse  to  the  community.  No  need  to  spay  the  pros- 
titute or  castrate  the  criminal;  they'll  do  it  themselves  if  they  are  just  given  a 
little  time. 

To  say  that  prostitution  involves  fearful  and  widespread  suffering  to  innocent 
women  and  children  would  be  ks  true  as  it  is  pitiable  and  harrowing,  but  "a  com- 
panion of  fools  shall  be  destroyed"  is  no  vengeful  threat,  but  a  simple  statement 
of  a  stern,  necessary  law,  of  highest  value  to  the  race.  The  only  way  to  check  its 
ravages  is  to  reduce  to  the  lowest  possible  limit  the  class  upon  which  it  is  sure 
(and  ought)  to  act.  And  the  only  way  agenucy  of  any  value  in  this  work  is  edu- 
cational, education,  education!  Legislation  is  useless,  "regulation"  worse  still. 
Awake  society  to  the  fact  that  the  rake  does  not  make  the  best  husband,  especially 
awake  the  "managing  mammas,"  who  are  for  the  most  part  either  shamefully 
ignorant  and  determined  to  keep  their  charges  so,  or  as  conscienceless  in  these 
matters  as  the  slave-dealer  of  the  Soudan. 

Above  and  beyond  all,  we  should  foster,  glorify,  deify,  is  necessary,  the  one 
instinct  in  man's  bosom  which  can  master  the  sexual,  the  highest,  the  holiest,  the 
strongest  of  which  he  is  capable — his  love  to  the  one  woman  who  is,  or  is  to  be,  all 
the  world  to  him.  Once  touch  this  spring  and  he  is  safe.  Well  may  all  of  clearest 
and  deepest  vision  among  us,  the  poets,  never  weary  of  singing  its  praise.    The  age 


178 


DETROIT     MEDICAL     JOURNAL 


of  chivalry  should  be  brought  back  in  nobler,  truer  form.  Lust  laughs  at  opposi- 
tion and  exults  in  danger,  but  sinks  ashamed  at  the  whisper  of  love.  Impress 
upon  every  man,  not  his  own  danger,  but  that  of  his  wife  that  is  to  be,  of  his 
children  yet  unborn.  Nay,  further,  make  him  see  that  the  last  insult  he  can  offer 
to  the  one  for  whom  he  would  cheerfully  lay  down  his  life  is  to  make,  in  the  burn- 
ing words  of  the  apostle,  her  "members  the  members  of  a  harlot."  Do  this, 
and  prostitution  will  disappear  from  the  face  of  the  earth." 


NEW  INSTRUMENTS  AND  DEVICES 

Mention  of  new  instruments  and  devices  in  this  department  Is  entirely  compliment- 
aj-y   and  articles  illustrated   are   judged   on    their   merits. 

We  Invite  manufacturers  and  physicians  to  send  us  matter  suitable  for  publica- 
tion under  this  head.  A  description  of  the  device  and  an  electrotype  or  half-tone  with 
a  base  not  greater  than  two  and  five-eighths  inches  should  be  sent. 

Always  mention  the   price   of   the   article    in   question. 

The  management  cannot  undertake  to  return  cuts  unless  postage  for  same  accom- 
pany the  letter  with  which  they  are  sent. 

To  Our  Readers— The  Detroit  Medical  Journal  publishes  descriptions  of  such  aids  to 
the  profession  as  It  knows  to  be  reliable  and  trustworthy.  We  shall  be  pleased  to  fur- 
nish information  as  to  the  articles  mentioned,  or  the  articles  themselves,  upon  receipt 
of  an  Inquiry. 


Invalid   Elevator. 

•  This  machine  seems  the  most  practical 
and  useful  article  of  the  sort  on  the  market. 
Some  such  apparatus  is  necessary  for  the 
safe  handling  of  heavy  patients  who  are  un- 
able to  move  themselves.  By  means  of  this 
crane,  a  nurse  can  handle  a  patient  without 
assistance  and  with  much  more  safety  and 
comfort  than  in  any  other  way.  The  ma- 
chine can  be  bolight  or  rented. 


Expanding  Douche  Point. 
This  new  douche  point  is  intended  for  houoG- 
hold  use,  but  is  entirely  fitted  for  a  surgical  in- 
strument. It  can  be  taken  apart  for  sterilizing 
and  cleaning  and  is  entirely  of  metal.  The  me- 
chanical Scheme  is  very  simple,  yet  it  is  the 
most  perfect  arrangement  for  a  cleansing  douche 
with  which  we  are  acquainted.  A  moment's  con- 
sideration of  the  anatomical  formation  will  suf- 
fice to  convince  one  that  the  ordinary  small 
rubber  douche  point  must  be  a  very  imperfect 
cleansing  a?ent,  as  well  as  itself  often  a  bearer 
of     infection.     Price,  $5.00. 


BOOK    REVIEWS  179 

BOOK  REVIEWS 

Drink  Restriction.  By  Von  Noorden  and  Salomon.  E.  B.  Treat  &  Co.  86  pp.  $.75. 
This  is  translated  from  one  of  the  six  monographs  by  Von  Noorden,  upon  the 
"Pathology  and  Therapy  of  Disorders  of  Metabolism  and  Nutrition."  The  liter- 
ture  is  reviewed  and  the  investigations  of  other  men  carefully  criticized;  then 
there  follows  the  description  of  the  authors'  own  experiments  on  human  subjects. 
The  monograph  represents  recent  and  thorough  work,  and  contains  valuable  in- 
formation for  the  scientific  clinician,  regarding  the  restriction  of  fluids  in  obesity, 
chlorosis,  cirrhosis,  and  hemorrhage. 


The  Historical    Relations  of   Medicine  and  Surgery  to  the   End  of  the  Sixteenth 

Century.     An  address  delivered  at  the  St.  Louis  Congress    in    1904.     By  T. 

Clifford  Allbutt,  M.  A.,  M.  D.,  Hon,  M.  D.    (Dublin),  Hon  LL.  D.    (Glasgow), 

Hon.  D.  Sc.  (Oxf.  and  Vict.),  F.  R.  C.  P.,  F.  R.  S.,  F.  L.  S.,  F.  S.  A.,  Regius 

Professor  of  Physics  in  the  University   of   Cambridge,   etc.     London:    Mac- 

millan  &  Co.,  Limited;  New  York:  The  Macmillan  Co.    1905. 

This  small  volume  is  admirable  in  several  particulars.     The  subject  matter 

— at  once  of  great  interest  and  considerable  difficulty — is  carefully  treated  by  one 

of  our  most  erudite  medical  writers ;  his  treatment  of  the  subject  would  always  be 

of  interest.     In  addition  the  book  is  written  in  charming  English  and  would  be 

pleasant  reading  were  it  of  no  historical  value.     The  combination  of  charm  and 

permanent  value  renders  the  volume  of  unusual  worth. 


A  Systematic  Treatise  on  Materia  Medica  and  Therapeutics  with  Reference  to  the 
Most  Direct  Action  of  Drugs.  By  Finley  Bllingwood,  M.  D.  Professor  of 
Materia  Medica  in  Bennett  College,  Chicago,  Editor  of  Chicago  Medical  Times, 
etc.  With  a  condensed  consideration  of  Pharmacy  and  Pharmacognosy  by 
Prof.  TJri  Lloyd,  of  Cincinnati.  Fifth  edition,  revised  and  enlarged.  Chicago 
Medical  Times  Publishing  Co.    1905. 

This  new  edition  of  the  chief  reference  volume  of  the  Eclectic  medical  school 
of  the  United  States,  commands  a  good  deal  of  interest.  It  contains  many  details 
about  the  application  of  drugs  to  particular  symptoms  which  are  not  found  in 
therapeutic  treatises  of  the  regular  school.  Consideration  is  largely  given  to  the 
group  of  indigenous  botanic  remedies  of  which  the  regular  profession  undoubtedly 
knows  too  little,  and  there  is  much  of  value  to  be  added  to  our  therapeutic  re- 
sources from  the  labors  of  our  eclectic  brethren. 

The  volume  is,  to  our  mind,  by  no  means  a  satisfactory  text  on  the  subject  of 
materia  medica  and  therapeutics,  but  a  perusal  of  many  of  its  chapters  by  those 
familiar  with  modern  pharmacology  will  prove  both  interesting  and  suggestive. 


The  Diagnosis  of  Diseases  of  Women.  A  treatise  for  students  and  practitioners. 

By  Palmer  Findley,  B.  S.,  M.  D.     Second  edition,  revised  and  enlarged.     6^^x 

9l^  in.;   588  pages;   222  engravings  and  59  colored  plates.     Philadelphia  and 

New  York:     Lea  Brothers  &  Co.,  1905. 

It  is  a  rather  remarkable  fact  that  among  the  multiplicity  of  English  text 
l>ooks,  there  is  but  one  treating  exclusively  of  gynecologic  diagnosis.  It  is  a  subject 
in  which  the  young  graduate  is,  as  a  rule,  but  indifferently  trained,  for  the  great 
majority  of  students  have  but  limited  opportunities  in  special  clinics.  This  work 
of  Findley's,  of  which  the  second  edition  has  just  appeared,  is  therefore  most 
important  and  will  continue  to  be  appreciated  not  only  by  students  but  by  more 
experienced  men  as  well. 

About  one-fourth  of  the  volume  is  given  up  to  the  general  methods  of  diagnosis 
and  the  remainder  to  special  subjects,  beginning  with  pregnancy  and  covering  the 
morbid  conditions  of  the  various  organs  in  a  thorough  and  systematic  manner. 
Part  III.  deals  with  the  diagnosis  of  the  diseases  of  the  urinary  organs,  cystoscopy 
being  well  discussed. 

A  somewhat  more  thorough  section  on  the  differentiation  of  appendicitis  and 
pelvic  inflammatory  conditions  would,  in  our  opinion,  add  to  the  value  of  the 
book,  as  would  ialso  a  section  on  the  diagnosis  of  rectal  troubles. 

The  author  emphasizes  throughout  the  vast  importance  of  pathology  and  the 
necessity  of  making  a  knowledge  of  both  micro-  and  macroscopic  lesions  the  found- 
ation of  all  clinical  work.     This  emphasis  alone  makes  the  work  a  valuable  one 


180  DETROIT     MEDICAL    JOURNAL 

and  one  which  can  be  safely  recommended  to  everj'  student,   practitioner  and 
frpecialist. 

The  printer  has  done  his  work  well.    The  illustrations  are  well  chosen  and  of 
excellent  quality.  B.  R.  S. 


The  Pharmacopoeia  of  the  United  States  of  America.     Eighth  decennial  revision 

official  from  Sept.  1-1905.    P.  Blakiston's  Son  &  Co.,  Agents,  Philadelphia. 

The  new  pharmacopoeia  is  ready  for  distribution  and  will  become  official  on 
September  first.  The  chairman  of  the  Committee  of  Revision,  Mr,  Joseph  P.  Rem- 
ington, calls  particular  attention  to  the  changes  made  in  three  important  officinal 
tinctures.  The  strength  of  Tincture  of  Aconite  has  been  reduced  from  35  per  cent. 
to  10  per  cent.;  Tincture  of  Veratum  from  40  per  cent,  to  10  per  cent.;  Tincture 
of  Strophanthus  is  incerased  from  5  per  cent,  to  10  per  cent.  These  changes  are 
made  in  accordance  with  standards  adopted  by  the  International  Conference  on 
Potent  Remedies  held  at  Brussels  in  1902,  the  object  being  to  make  these  drugs 
uniform  in  strength  throughout  the  world. 

There  have  been  121  articles  added  to  the  pharmacoepia,  including  many  long 
familiar  names  such  as  guaiacol,  aromatic  fluid  extract  of  rhamni  purshianae,  co- 
caine, codeine  phosphate  and  sulphate,  bismuth  subgallate,  water,  antipyrin,  mag- 
nesium sulphate  effervescent,  talcum  and  many  more  who  seem  greatly  belated  in 
receiving  official  recognition.  153  articles  heretofore  officinal  are  omitted  in  the 
revision,  also  including  familiar  titles  such  as  massa  copaiba,  spirits  of  lemon,  oil 
of  bergamot.  Acidum  carbolicum  is  now  phenol;  salol  is  now  phenylis  salicylas; 
spiritus  glonoini  is  spiritus  glycerylis  nitratis.  One  very  sensible  change  affects 
all  the  fluid  extracts.  Instead  of  extractum  aconiti  fluidum,  one  now  writes  flui- 
dextractum  aconiti.  The  official  English  titles  are  of  course  changed  to  corres- 
pond. Now  instead  of  saying  arseneous  acid,  one  must  call  for  arsenic  troixide; 
chromic  acid  is  chromium  trioxide;  resin  is  now  rosin,  and  salol  is,  in  English, 
phenyl  salicylate.  Examples  might  be  multiplied.  Mention  should  also  be  made 
of  the  standardizing  of  52  preparations  for  which  no  definite  strength  had  hereto- 
fore been  assigned. 

Enough  has  been  said  to  show  that  the  changes  are  many  and  important.  The 
revision  has  been  no  form  merely,  but  has  produced  very  marked  changes  in  a 
good  direction  in  our  pharmacy.  The  changes  in  strength  in  several  drugs  will 
make  necessary  a  change  in  dosage,  and  this  fact  should  be  kept  in  mind  in  pre- 
scribing after  September  first.  The  principal  changes  have  been  noted  above,  but 
there  are  many  others  in  drugs  less  widely  usd. 


RECEIVED: 

(Grateful  acknowledgement  of  the  receipt  of  the  follo-wlng  Is  hereby  made.      Further 
notice  in  our  review  column  may  be  given). 

Preliminary  Report  of  a  Case  of  Lichen  Scrfulosorum.  By  N.  E.  Aronstam,  M.  D. 
Detroit.     Reprint." 

Albumin  in  the  Urine  of  Apparently  Healthy  Children.  By  Wm.  A.  Edwards,  M.  D., 
Los  Angeles,  Cal.     Reprint. 

Text-book  of  Physiology.  By  Winfield  S.  Hall,  M.  D.  Professor  of  Physiology  in 
Northwestern  University  Medical  School,  Chicago.  Second  edition,  1905.  Lea 
Bros.  &  Company. 

Changes  in  the  Pharmacopoeia  of  the  United  States.  Eighth  Decennial  Revision. 
By  Reid  Hunt  and  Murray  Gait  Motter.  Bulletin  No.  23 :  Hygienic  Laboratory, 
Public  Health  and  Marine  Hospital  Service  of  the  United  States,  Washington, 
1905. 

Michael  MacDonagh's  readable  article,  "The  Spoils  of  Office,"  in  The  Living  Age 
for  July  29,  groups  facts  relating  to  the  emoluments  and  expenses  of  office-hold- 
ing in  Great  Britain  along  with  interesting  reminiscences  of  public  men,  in  the 
writer's  usual  piquant  style. 

"Handbook  of  Anatomy."  Being  a  complete  Compend  of  Anatomy,  Including 
the  Anatomy  of  the  Viscera  and  Numerous  Tables,  by  James  K.  Young,  M.  D. 
Professor  of  Orthopaedic  Surgery,  Philadelphia  Polyclinic;  Clinical  Professor 
of  Orthopaedic  Surgery,  Woman's  Medical  College  of  Pennsylvania;  Instructor 
in  Orthepaedic  Surgery,  University  of  Pennsylvania.  Second  edition,  revised 
and  enlarged.  With  171  engravings,  some  in  colors,  404  pages.  $1.50  net.  F. 
A.  Davis  Company,  Philadelphia. 


DETROIT     MEDICAL     JOURNAL 


XV 


ADNEPHRIN  SOLITION 


We  offer  it  in  pint,  1-2  pint,  1-4  pint  and 
ounce  bottles. 

Makers  of  other  solutions  of  the  adrenal 
(suprarenal)  active  principle,  offer  only  ounce 
sizes. 

Why? 

Large  users  of  Adnephrin  Solution — hospitals, 
specialists,  etc. — asked  us  for  the  larger  sizes. 
We  complied  gladly,  for  Adnephrin  Solution  is 
permanent,  does  not  turn  pink  or  brown — a  cer- 
tain sign  of  decomposition.  Hence  it  can  be 
marketed  in  large  bottles. 

No  other  such  solution  is  permanent,  hence 
no  other  can  be  safely  marketed  in  large  bottles  ; 
even  that  in  small  bottles  generally  turns  pink  un- 
less used  up  quickly. 

The  superior  stability  of  Adnephrin  Solution 
is  not  its  only  advantage.  It  is  absolutely  sterile, 
uniform  in  strength  (1 -to- 1000),  free  from  excess- 
ive acidity,  and  is  proved  by  careful  physiologic 
test  at  least  equally  as  active  as  the  very  best  of 
competing  preperations. 

Your  druggist  supplies  it  at  75  cents  per  oz. 
vial ;  we  send  a  trial  bottle  free  if  you  ask  it. 

We  also  offer  Adnephrin  Oil  Spray,  Adneph- 
rin Emollient  and  Adneph-rin  Suppositories. 


o  FREDERICK  e 

5tearn5 

£CO. 

DETROIT, MICH.  U.S. A 

WINDSOR. ONT.- LONDON,  ENG.-NEW  YORK. CITY. 


XVI 


DETROIT  MEDICAL   JOURNAL 


A  LACK  OF  LEAK 


is  but  ONE  of  the  salient  features  of  the 


^XTCHLi;5j 


All  Metal 
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(Our  latest  production) 


It  is  strong,  perfect  working,  and  easily  manipulated. 

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There  is  a  choice  of  tips  for  every  kind  of  work, — ear, 
abscess,  catheter,  cystoscopic,  eustachian,  urethral  and  vet- 
erinary. 


If  you  are  a  Physician,  Surgeon,  Veterinarian,  or  represent  an  institution,  here  is 
a  valuable  addition  to  your  working  equipment.  Write  to  us  for  particulars;  or  bet- 
ter, ask  to  see  it  at  your  dealer's. 

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1  "              "            """....  2.50  6  ounce  "            "  ""....  5.00 

2  "              "            """....  3.00  8  ounce  "            "  ""....   5.50 
One,  three  or  six  inch  veterinary  tip  supplied  in  place  of  two  tips  as  above  if  de- 
sired. 

^  ^  i?  ii"  ^  ^  ii* 

THE  RANDALL -FAICHNEY  CO. 

BOSTON,  MASS 


PUBLISHER'S    DEPARTMENT. 


XVll 


PUBLISHER'S  DEPARTMENT. 


Some  Neglected  Symptoms  of  Non- 
Surgical  Gynecology* 

By  John  A.  Hale,  M.  D., 
Alto  Pass.  III. 

From   the   Medical   Herald,    of   St,    Joseph,    Mo. 


It  is  but  a  lack  of  inquisitiveness  on  the  part 
of  the  general  practitioner  that  has  brought  about 
a  condition  of  things  in  gynecological  practice  that 
warrants  the  assertion  so*  often  reiterated  in  cur- 
rent surgical  literature  that  "Modern  gynecology 
belongs,  practically,  to  the  field  of  operative  sur- 
gery." 

The  successful  physician,  with  a  characteristic 
personality  of  inauisitiveness,  can  boldly  refute 
such  assertions  and  substantiate  his  refutation  by 
the  thankfulness  of  a  happy  clientele  of  woman- 
kind released  from  a  thraidom  of  suffering  by  his 
inquisitiveness. 

Diseases  of  the  female  organs  of  generation 
are  more  common  than  any  but  a  physician  can 
suppose,  and  surgical  gynecology  has  become  a 
necessity  from  an  early  neglect  of  backaches, 
spineaches  and  headaches,  followed  by  irregular, 
scanty,  painful,  delayed  or  suppressed  menstrua- 
tion during  girlhood.  The  inquisitive  physician 
rushes  not  into  instrumental  interference,  nor 
sends  such  patients  to  certain  specialists  for  offi- 
cious mutilation,  but  first  a  volley  of  seek-farther 
questions  at  the  patient  which  elicit  the  informa- 
tion that  such  patient  passed  her  days  of  ap- 
proaching puberty  in  an  over-crowded  public 
school,  or,  worse,  in  a  jail-like  boarding  school 
for  young  ladies,  adding  fuel  to  the  fire  of  antag- 
onism between  brain  and  indigestible  foods,  the 
body  growth  lags  behind,  leaving  the  imprint  of 
the   unequal   struggle   on   the  reproductive   organs. 

With  poorly  established  sexual  functions  and 
a  perfect  disregard  for  menstrual  week,  the  un- 
developed woman  leaves  school  to  plunge  into  a 
vortex  of  social  dissipation,  followed  later  by  an 
assumption  of  wifely  duties  and  responsibilities 
toward  a  husband  who  has  seen  only  her  bewitch- 
ing face  and  not  her  frail  body. 

Ts  it  hard  to  fa.thom  the  reason  why  so  many 
such  wives  at  first  tolerate  marriage  obligations 
and  later  resent  and  loath  them  when  the  poor, 
broken-down  sexual  system  refuses  longer  to  con- 
tinue functions  for  which  it  was  made,  but  care- 
lessly unfitted? 

Is  not  such  a  condition  a  cause  for  dread  of 
maternity  on  the  part  of  the  woman  which  often 
leads  to  criminal  abortion,  with  all  its  attendant 
sequences? 

To  the  Inquisitiveness  of  the  successful  physic- 
ian must  be  added  a  power  of  positiveness.  where- 
in he  may  teach  both  the  husband  and  wife  some- 
thing they  should  know  before  their  carelessness 
brings  about  these  later  conditions  which  require 
the   necessity   of   mutilation. 

The  woman  suffering  from  continued  nervous- 
ness, weariness,  wakefulness,  headache  and  back- 
ache needs  the  services  of  a  physician,  and  not 
a  surgeon.  Likewise  such  symptoms  as  scanty, 
painful,  delayed  and  suppressed  menstruation 
shouM  be  under  the  care  of  a  physician  and  not 
an  over-zealous  surgeon.  Prolapsus,  leucorrhea, 
ulcerations,  chronic  inflammations,  congestions 
and  enlargements  are  purely  the  outcome  of  neglect 
of  just  such  symptoms  as  named.  The  first- 
named  symptoms  are  but  the  assertions  of  Na- 
ture that  she  is  tired  of  the  unequal  load,  and  if 
not  relieved  she  will  resist  no  longer,  come  what 
will. 

A  judicious  investigation  of  seemingly  insigni- 
ficant details  and  close  application  to  the  technique 
of  examination  in  the  early  stages  of  such  cases 
will  reveaJ.  constipation,  congested  mucus  lining 
of  the  vagina,  and  irritable  bladder,  with  diffuse 
hyperaemia  of  all  pelvic  structure  apd  loss  of 
organic  or  respiratory  rhythm;  that  subtle  thrill 
which  extends  over  the  whole  body  svnchronous 
with  the  beating  of  the  heart  and  motion  of  the 
lungs,  plainly  perceptible  to  the  trained  eye  looking 
upon  healthy  pelvic  viscera.  Quick  must  be  the 
relief  of  this  engorgement,  with  its  pernicious  nu- 
trition of  the  parts  and  concomitant  accumulation 
of  excrementitious  matter. 

First    and    foremost    in    the    treatment    of    this 


condition  comes  the  remedy  of  absolute  rest  to 
the  parts,  and  then,  but  no  less  important,  is  the 
removal  of  improper  dress  and  the  re-establish- 
ment of  abdominal  breathing  to  restore  proper 
circulation  in  the  pelvic  viscera.  Treatment  for 
the  removal  of  constipation  is  self-suggestive; 
rest  we  can  enjoin  upon  our  patient,  and  ab- 
dominal breathing  we  may  advise,  but  all  animal 
cells,  whether  single  or  united  in  tissues  or  in  or- 
gans, consume  a  certain  aniount  of  matter,  and 
those  chemical  changes  by  which  material  brought 
to  the  tissues  and  organs  by  the  blood  and  trans- 
formed into  other  products  through  the  activity 
of  the  living  cells  which  liberation  of  life  energy, 
must  be  maintained  by  a  continued  inherent  thrill 
or  respiratory  rythm.  and  a  constant  supply  of 
chemical  products.  This  same  chemical  agent 
must  not  induct  a  destructive  blood  metamor- 
phosis, but  supply  food  for  the  debilitated  vitality. 
For  such  action  we  must  seek  some  combination 
of  the  old  and  well-tried  remedies  of  ergot  and 
apium,   with   acceptable  haemagogues. 

The  auestionable  action  heretofore  exhibited  by 
various  preparations  of  such  remedies  has  been 
due,  as  clinically  proven,  to  the  component  resinous 
compounds  of  the  apium  in  the  combination.  In 
Ergoapiol  (Smith)  the  active  principles  of  apium 
have  been  isolated  and  with  ergot  made  to  form 
an  acceptable  and  agreeable  compound  with  invig- 
orating haemagogues,  proving  of  unquestionable 
benefit  in  such  conditions  as  mentioned  in  this 
article. 

When  the  general  practitioner  awakens  to  his 
responsibility,  we  will  have  less  of  these  conditions, 
a  continuation  of  which  invariably  produces  a 
capillary  varicosis,  with  its  train  of  evils,  mani- 
fested more  frequently  by  copious  and  disagreeable 
discharges  called  leucorrhea.  But  even  as  late 
as  in  this  last-named  condition  the  physician  will 
learn  that  Ergoapiol  (Smith)  judiciously,  consist- 
entlj--  and  determinedly  administered,  will  prevent 
much    needless    mutilation    by    effecting   a   cure. 

Pre-emption  of  space  for  case  reports  on  this 
subject  would  scarcely  be  justifiable,  when  each 
reader  may  cluster,  the  facts  herein  stated  around 
well-known  principles  and  evolve  therefrom  a  rat- 
ional solution  of  treatment  for  diseases  involving 
the   female   genitalia. 


Notice*  ' 

Armour  &  Co.  announce  their  readiness  to  fur- 
nish the  Parathyroid  substance  in  powdered  form, 
in  one   drachm  vials,   at  $1.50  per  drachm. 

The  parathyroid  glands  are  very  small,  and  so 
hard  to  get  out  that  the  material  can  be  supplied 
only   in  very  small   quantities. 

The  Parathyroid  substance  has  been  suggested 
in  the  treatment  of  paralysis  agitans,  ex-oph- 
thalmic  goitre,    etc. 


Entero-G>Iitis  and  Cholera  Infantum* 

Antiphlogistine  produces  results  in  cholera  in- 
fantum that  can  not  be  obtained  in  any  other 
way.  Pain  is  reduced,  restlessness  is  soothed  and 
the  tossing,  moaning  patient  falls  into  a  quiet,  rest- 
ful sleep.  And  why  not?  A  moment's  thought 
will  convince  you  that,  since  the  intestines  and 
possibly  the  peritoneum  are  infiamed.  an  applica- 
tion which  so  rapidly  reduces  inflammation  in 
other  parts  of  the  body  must  have  a  beneficial 
action  here.  Consider  also  that  in  this  case,  act- 
ing directly  upon  and  reflexly  through  the  solar 
and  hvpogastric  plexuses,  it  relieves  the  shock 
which  is  so  invariably  a  serious  part  of  the  symp- 
tom  complex.  ,  ^,  , 

Apply  hot  to  the  abdomen  about  14-mch  .thick 
and    cover   with    absorbent    cotton.    >    ,     ' 


S«n-Pa$n  and  Other  Pain* 

In  the  pain  and  pyrexia  produced  by  exposure  to 
the  rays  of  the  sun.  which  is  common  in  this  coun- 
try, and  particularly  in  our  large  cities,  during 
the  summer  solstice,  antikamnia  tablets;  in  addi- 
tion to  cold  douches,  are  the  best  remedy.  Anti- 
kamnia tablets  reduce  temperature  by,  increasing 
radiation  of  heat  from  the  body,  and  diminishing 
heat  production.  They  stimulate  the  glandular  sys- 
tem, particularly  the  sudorific  glands.  In  many 
cases  their  diaphoretic  action  is  phenomenal.  They 
act  as  an  analgesic  by  ol5t!unding  the  sensibilities 
of  the  vaso-motor  and  sensory  nerves.  They  seem 
to  tranquil ize  the  ganglionic  centers  of  the  whole 
nervous  system  and  have  but  slight  action  on  th^ 
brain.      We  mean  by  this,  that  they  do  not  stupef^r 


XVIII 


PUBLISHER'S    DEPARTMENT. 


nor  produce  unconsciousness.  They  seem  to  have 
no  disturbing  influence  on  the  kidneys.  They  have 
a  happy  effect  in  nearly  all  neurotic  troubles  and 
occupy  a  oermanent  position  in  therapeutics.  Brief- 
ly stated. 'they  are  indicated  in  sun-pain,  cephalal- 
gia, neuralgia,  attacks  of  acute  rheumatism,  sci- 
atica, dysmenorrhoea,  irregularities  and  all  pain- 
ful conditions. 

In  the  treatment  of  conditions  where  it  is  Import- 
ant to  exhibit  quinine,  the  action  of  Antikamnia 
and  Quinine  Tablets  will  be  found  specially  de- 
sirable The  antikamnia  not  only  relieves  the  pain, 
but  presents  any  disturbance  of  the  nervous  sys- 
tem,  so  frequent  when  quinine   is  given  alone. 


Acute  Prostatitis, 

Whoever  has  observed  the  prompt  and  gratifying 
effect  of  topical  application  of  dry  cold  in  acute 
prostatitis,  the  relief  secured  thereby  from  painful 
micturition  or  ischuria,  will  not  resort  to  the  old- 
fashioned  remedies,  as  leeches,  warm  fomenta- 
tions, Sitbaths.  opiates,  the  more  so  will  he  dis- 
card these  obsolete  means  since  dry  cold  early 
applied  is  known  to  be  the  best  prophylactic 
against  suppuration.  Equally  gratifying  is  topical 
application  of  dry  heat  in  case  of  chronic  periostitis 
for  it  stimulates  circulation,  aids  elimination  of 
detritus  masses  and  promotes  formation  of  new 
fibrous  tissue  to  fill  up  space  left  by  destructive 
inflammatory  process.  In  the  Zerodone  we  have 
a  contrivance  to  apply  either  dry  heat  or  dry  cold, 
for  we  may  have  either  warm  water  or  ice  water 
circulate  through  its   channels. 


A  Simple  Nasal  Douche. 

Our  attention  has  been  called  to  a  simple,  but 
ver>'  effectual  nasal  douche  designed  by  Dr.  H.  M. 
Dunlap.  This  little  device,  also  the  manner  of 
using  same,  is  shown  in  the  accompanying  illus- 
tration. The  douche  is  so  constructed  as  the  fluid 
Is  drawn  up  from  the  tumbler  as  shown  in  the 
illustration,  air  is  drawn  in  with  the  fluid,  causing 
the  latter  to  be  broken  up  into  drops  and  thrown 
Into  every  part  of  the  nasal  passages,  producing 
a  sort  of  percussion  effect  with  just  enough  force 
to  dislodge  the  adherent  secretions.  By  using  an 
alkaline  solution  the  mucous  membrane  is  very 
effectually  cleansed  and  prepared  for  the  appli- 
cation of  any  desired  medicament,  either  with  ap- 
plicator, sprays  or  nebulizer.  One  special  advant- 
age of  a  douche  of  this  kind  lies  in  the  fact  that 
it  is  absolutely  impossible  to  introduce  the  fluid 
into  the  nasal  tjavities  or  pharnyx  under  any  pres- 
sure, and  there  is  therefore  absolutely  no  danger 
of  injuring  the  middle  ear.  It  is  a  particularly 
desirable  device  to  place  in  the  hands  of  patients 
for  home  treatments.  In  this  way  the  nasal  pas- 
sages can  be  kept  in  an  aseptic  condition  by  fre- 
quently   repeated    applications. 


Notice. 

The  suprarenal  capsules  are  known  variously 
as  adrenals,  adrenal  capsules,  adrenal  glands,  sup- 
raenals.  suprarenal  glands,  suprarenal  bodies, 
ephinephris,  adnephris,  and  there  are  still  other 
names  for  the  active  principles  of  the  substance, 
but  the  one  perfect  liquid  preparation  of  this  ac- 
tive constituent  is  called  Suprarenalin  Solution— a 
fact  worth  remembering  by  pharmacists  and  phy- 
sicians. 


♦^ 


■».>■■■■  ^#  ■  ■  < 


i.»i  »  >  .»..•. ■•■4 


THE  PRI-MO 

LADIES'  SYRINQE. 


The  Only  One 
in  its  class: 


Nothing  Els« 
Like  It. 


E.  J.  HUSSEY  &  CO., 

I    80  John  Street,  NEW  YORK< 


Treatment  of  Felons. 

Felons  are  classed  as  minor  surgery  and  yet 
many  a  finger  has  been  lost  through  their  careless 
treatment.  Antiphlogistine  is  a  specific  In  incipi- 
ent cases.  Apply  hot,  change  every  6  or  8  hours, 
and  resolution  will  as  a  rule  occur  without  the 
formation    of    pus. 

If  pus  has  already  formed  incise  deeply  and  free- 
ly. Thoroughness  Is  essential.  Evacuate  and 
cleanse  with  a  suitable  antiseptic.  Insert  a  drain- 
age tube.  Surround  the  finger  with  Antiphlogis- 
tine. Cut  the  drainage  tube  14  inch  above  the  sur- 
face of  the  Antiphlogistine.  Cover  all  with  ab- 
sorbent cotton  and  a  bandage.  The  results  will 
be  satisfactory. 


Menopause. 

Preceding  and  succeeding  the  final  cessation  of 
ovulation  and  menstruation,  physical  and  psychical 
disturbances  of  a  more  or  less  serious  character 
are  frequently  observed.  Ergoapiol  (Smith)  be- 
cause of  its  tonic  effect  upon  the  female  gen- 
erative system  and  its  splendid  antispasmodic  In- 
fiuences,  is  of  unsurpassed  value  in  the  treatment 
of  the  various  disturbances  incident  to  this  period. 


Intestinal  Disorders  Due  to  Lack  of 
Normal  Intestinal  Alkalines. 

At  this  period  of  the  year  we  are  called  upon 
to  consider  carefully  the  application  of  therapeutic 
measures  to  be  adopted  in  the  treatment  of  dis- 
eases of  the  gastro-intestinal  tract.  Conditions 
met  In  these  cases  have  a  marked  degree  of  simi- 
larity, due  primarily  to  a  faulty  or  altered  secre- 
tion of  intestinal  juices,  broken  down  mucous 
membrane,  together  with  fiuids  of  intensely  acid 
reaction  loaded  with  pathogenic  bacteria.  The 
logical  treatment  Indicated  would  call  for  a  prompt 
removal  of  the  source  of  Infection  and  the  res- 
toration of  normal  secretion. 

A  prominent  practitioner  in  the  south,  whose 
wide  experience  justifies  authority,  recently  em- 
bodied in  a  paper  the  following  statement:  "In 
diseases  of  the  intestinal  tract  in  children  or 
adults,  whatever  the  diagnosis  may  be.  we  always 
trace  the  origin  of  the  trouble  to  a  Want  of  Al- 
kalines to  correct  an  excess  of  acidity  during 
the  digestive  process."  This  is  of  deep  interest 
to  us,  as  it  gives  the  key  to  the  market  results  fol- 
lowinfe-  the  administration  of  the  alkaline  antisep- 
tic. Glyco-Thymollne.  which  not  only  corrects  ex- 
isting hyperacidity  with  Its  concomitant  symptoms, 
but  causes  by  Its  exosmotlc  property  a  rapid  de- 
pletion of  the  engorged  membrane  and  a  stimula- 
tion of  the  glandular  system  to  normality,  where- 
by the  proper  amount  of  alkaline  fiuids  will  be  se- 
creted. Therefore,  It  Is  well  to  remember  that 
Glyco-Thvmoline  not  only  corrects  the  effects  of 
disease,  but  aims  to  re-establish  those  processes  of 
digestion   and   assimilation   which   are    wanting. 

In  severe  cases  of  Cholera  Infantum.  Dysentery, 
Ileo-Colitis,  etc.,  the  solution  should  be  adminis- 
tered as  a  colon  flush,  using  a  10  per  cent  solu- 
tion of  about  100  per  cent  F.  This  treatment. 
conibin-='d  witli  T  to  2  :xrain  doses  m  r  .-)r:iiii  s-crves 
to  rapidly  eliminate  all  toxins,  promote  an  asceptic 
condition  of  the  bowel  and  to  encourage  what  is 
most  needed— the  secretion  of  normal  alkalines. 


Good  Bone  Union  Secured  with- 
out Shortening   or   Deformity 

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Adjustable  to  any  patient,  either 
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Union;  Knee  or  Hip- hint  Disease; 
Ankle,  Leg,  Knee,  Thigh,  and  Hip 

FRACTtRES   iT^JJ: 

Wire  Orders  Expressed  at  once.  Sold 
by  J.  F.  Hartz  Co.,  Detroit  and  Toronto, 
and  leading  instrument  houses.  Send 
Postal  for  new  booklet,  etc. 

Ambulatory  Pneumatic  Splint  Mfg.  Co. 

163  Randolph  Street,  Chicago 


DETROIT   MEDICAL   JOURNAL 


XIX 


$3^  SAVED 

tTall  points  east  and  west 

VIA  THE    D&B    LINE. 


Oust  Two  Boats" 

^^  ETWEE Nf^ 

DEX^mT&  mjFFALO 


DETROIT  §  BUFF; 
5Tr^M50AT 


THE  DIRECT  AND  POPULAR 

ROUTE  TO  POINTS    EAST 

DAILY  SERVICE,   MAY  iOth 

Improved  Express  Service  (14  hours)  Between 

DETROIT  AND  BUFFALO 
Leave  DETROIT  Daily     -     5.00  P.  M. 
Arrive  BUFFALO    "         -      9.00  A.M. 

Connectinsr  'with  Morning:  Trains  for  all  Points  in  NEW 
lORK,  PENNSYLVANIA  and  NEW  ENGLAND  STATES. 

Through  Tickets  sold  to  All  Points,  and  Btigg^S^ 
Checked  to  Destination. 

Leave  BUFFALO  Daily  -     5.30  P.  M. 
Arrive  DETROIT       **        -     7.30  A.  M. 

Connectinjj  with  Early  Morning  Trains  for  Points 
^orth  and  West. 

Rate  between  Detroit  and  Buffalo  $3.50  one  way, 
80. 50  round  trip.  Berths  $1.00,  $1.50  j  Staterooms 
$2.50  each  direction. 

Send  2c  Stamp  for  Illustrated  Pamphlet. 

RAIL  TICKETS  HONORED  ON  STEAMERS 
All  Classes  of  Tickets  sold  reading  via  Grand  Trunk, 
Michigan  Central  and  Wabash  Railways  between  De- 
troit and  Buffalo  will  bo  accej)ted  for  transportation  on 
D.  &  B,  Strs.  in  either  direction  between  Detroit  and 
Buffalo.  A.  A.  SCHANTZ,  Q.S  &  P.T.M.,Detroit,Mich 


XX 


DETROIT  MEDICAL   JOURNAL 


t  A  RECENT  GOVERNMENT  TEST  i: 

SHOWS  THAT  33  PER  CENT  of  the  FEVER  THERMOMETERS 
SOLD  IN  THIS  COUNTRY  ARE  WORTHLESS 

100%  OF    TWIN"BULB    THERMOMETERS 

MEET  THE  GOVERNMENT  REQUIREMENTS 


REGISTER  QUICKER.  SHAKE  DOWN   EASIER,   AND    COST 
NO   MORE  THAN  MANY  OTHER  MAKES. 


i 


FOR  SALE  BY  AUL 

DEALERS  IN 

PHYSICIANS'  SUPPLIES 


PRICES 
a  Minute  in  H.  R  or  Aluminum  Case, 
I        "         "      "      "           *•              ••  . 

H 


im  f 


Eacli,  $1.00 
i.as 
■  .50 


BECTON,  DICKINSON   &  CO.,   Makers,  N.  Y. 


Konseals  offer  the  most  rational  means  of  administer- 
ing powdered  drugs  in  absolutely  accurate  doses  without 
interfering  with  their  therapeutic  value  or  impeding  their 
entrance  into  the  circulatory  system. 

They  safeguard  hyperse,nsitive  palates  and  reduce  to 
a  minimum  the  possibility jc^f  nauseating  the  patient. 

Konseals  keep  indefinitely,  retain  their  solubility  for 
all  time  and  surpass  in  every  way  anything  of  a  similar 
ch^rajcter  hitherto  presented  to  the  medical  profession. 

Write  for  "The  Konseal,  Formulary^*  and  samples. 

J.  M.  GROSVENOR  &  CO.,    148   Pearl   Street,    Boston,  I.  S.  A. 


DETROIT    MEDICAL    JOURNAL 


XXI 


177B— Stand,  two  Pol- 
ished Plate  Glass 
Shelves  18x28. 
Nickel  Plated  Rail- 
ings. 

Price  $10.00 

Columbus  Regular  Ta- 
ble, Complete  as 
shown. 

Price  $25.00 


171— Three-pan  Revol- 
ving Wash-stand, 
deep  bowls,  with 
Nickel  Plated  Towel 
Rack. 

Price  $9.60 


Group  Complete 
$44.00 


2    Shallow    Basins    and    1-1    Gal. 
Single  Irrigator. 

Price  $12.00 


258     2  Deep  Bowls  and  Inst.  Tray  with 
2-1   Gal.  Irrigator. 

Price  $23.00 


The    Latest    Dust    and 
Damp  Proof 

Instrument 

Cabinet. 

Size  of  Polished  Plate 
Glass  Shelves  16x20 
inches.  Height  60 
inches.  All  four  sides 
made  of  double  strength 
Plate  Glass. 

Manufactured  on  Mod- 
ern Principles. 

ENTIRELY  NEW. 

Price  $40.00 


MADE  ONLY  BY 


The  Columbus  Aseptic  Furniture  Co. 


95-97  W.  Gay  St, 


COLUMBUS,  OHIO. 


Sold  through  Physicians'  Supply  Houses  and  Wholesale  Jobbers  only. 


xxu 


DETROIT    MEDICAL    JOURNAL 


GOVERNMENT  CERTIFICATES  msm^m^ 


Tagliabue's 

standard 

Clinical 

Thermometers 


If  you  desire  accurate  sen- 
sitive   Instruments,   procure 
from  your  dealer  a  Tagliabue 
No.  323  and  don't  allow  sub- 
stitution. .  -      J 
Price  as  low  as  any  so-called  special  Thermometers  which  are  so  loudly  advertised,  but  you  can  always  rely  on  a  Tagliabue  No 
222  being  the  Best  whether  Foreign  or  Domestic.     Furnished  a"    follows:  Tagliabue's  Standard  No.  222,  2  Minutes,  $1.00 
each ;  Tagliabue's  Standard  No.  323,  1  Minute,  $1.25  each  ;  Tagiiabue's  Standard  No.  222,  14  Minute,  $1.50  eacli. 

Genuine  instruments  are  all  engraved  with  my  name  aud  No.  222.  These  Thermometers  are  carried  in  stock  by  all  Reliable  In- 
strument and  Drug  Houses.  If  your  dealer  cannot  supply  these  goods,  write  me  direct,  enclosing  the  exact  amount  and  I  will  send  you 
what  you  may  order  by  mail.  CM  AS.  J.  TAGLIABtE  Mf  0.  CO.,  New  York. 


PROSTATITIS  AND  THE  ZERODONE  TREATMENT 

A  rectal  cooling  apparatus  for  the 
treatment  of  hemorrhoids,  acute  and 
chronic  prostatitis,  irritable  bladder,  etc. 

A  scientifically  constructed  apparatus 
to  maintain  during  treatment  a  circula- 
tion of  liquid  at  an  almost  freezing  tem- 
perature. 

The  Zerodone  is  being  offered  exclu- 
sively to  the  medical  profession. 

WAI.DEX  COMPANY.  99  P  BeeKman  St,,    NEW  YORK 


U/ye   ''Gilbert^' 

Obstetrical  Bag 

PATENTED 

Name   m.wkA    patent   marK   stamped 
OA  brass  plate  oa  every  ba^ 


TKe  best  combination 
PH^rsician's  ba^  oz&  tHe  market 


MADE    BY 


The  Clevef  and  Leather  Goods  Co. 

Mfr8.  Physicians'  Bags  and  Cases 
Cle-veland,  O. 


For  the  Application  of  Vaporized 
REMEDIES 

To  the  Lungs.  Throat  and  Nasal 
Passages. 

A  NEBULIZER  ^Too 


For  use  with 
nebulized  Oils, 
Balsams,  and 
other  Remedial 
Agents. 

Pamphlet  on 
Atomization  of 
Liquids  free  on 
request. 


Postpaid 

With  directions 
and  List  of  Val- 
uable Receipes. 


Tlie 

Glycol 

(Frade  Mark) 

No.  179 


Patented  March 
%  20.  1888:  Feb. 
^     24,   1891 


Produces  a 
Floating  Cloud, 
Containing  Re- 
m  e  d  y  in 
Substance,  read- 
ily received  by 
the  cells  of  the 
lungs. 


CODMAN  &  SHURTLEFF, 

^incorporatrd) 
SUPERIOR  SURGICAL  INSTRUMENTS. 
13-15  TREMONT  ST.,         BOSTON,  MASS 


DETROIT    MEDICAL    JOURNAL 


XXIIl 


Our  Trade  Mark 
is  a  Guarantee 
of  Quality, 


TRADE  MARK 


We  illustrate  two  new  pieces 
of  Victor  apparatus.  They, 
like  all  other  Victor  instru- 
ments, are  Durably  Made, 
Beautifully  Designed,  Thor- 
oughly Practical,  Mechanically 
and  Electrically  Correct. 


FULLY 
GUARANTEED 


VICTOR   No.  4  AIR  COMPRESSOR 


We  make  Mas- 
sage Apparatus, 
F  i  n  s  e  n  Lamps, 
Eye  Magnets, 
Cautery  Trans- 
formers, Electric 
Air  Heaters,  Wall 
Plates,  Current 
Controllers,  Sta- 
tic Machine  Mo- 
tors, Combination 
Instruments 


For  all 
Ctirrents 


"Write  for  Cat- 
alog  No.   23 


'if^TTfffflBagi^^ 


V  CTOR  BONE  SURGERY  OUTFIT 


Victor  Electric  Company 

61  MarRet  St.,  Chicago.  111. 


xxrv 


DETROIT    MEDICAL    JOURNAL 


THE  JOURNAL 


OF  THE 


MICHIGAN    STATE    MEDICAL 

SOCIETY 

(OFFICIAL  ORGAN) 

PUBLISHED  MONTHLY  UNDER   DIRECTION  OF  THE  COUNCIL 
A.   P.  BIDDLE.   M.  D.,  EDITOR  GUY  L.  CONNOR,  MNG.  EDITOR 

57   W.    FORT  STREET,    DETROIT,   MICH. 


HARRISON  JENKS,  M.   D. 
MEDICINE 

GUY  L.  CONNOR,  M.  D. 
NEUROLOGY 

MAX  BALLIN,  M.  D. 
SUGERY 

H.  S.  OLNEY.  M.  D. 

BACTERIOLOGY  &  PATHOLOGY 


COLLABORATORS 


$2.00  PER  YEAR 


B.  R.  SCHENCK,  M.  D. 

GYNECOLOGY  &  OBSTETRICS 
A.  P.   BIDDLE,  M.   D. 

DERMATOLOGY,    SYPHILIS    &    CUTANEOUS 

RADIOTHERAPY 
W.  J.  WILSON,  JR.,  M.   D. 

THERAPEUTICS  &  PHARMACOLOGY 
RAY  CONNOR,  M.   D. 

BOOK  NOTICE  DEPARTMENT 


SINGLE  COPY  20C 


MARVEL  "WHIRLING  SPRAY"  SYRINGE 


HE     LATE'T   A^D  EEST  SYRI^CEEVER 

INVENTED  TO  THOROUGHLY 

CLEANSE  THE  VAGINA 


THE    MARVEL, 

by  reason  of  its  peculiar  con- 
struction, dilates  and  flushes 
the  vaginal  passage  with  a 
volume  of  whirling  fluid, 
which  smooths  out  the  folds 
and  permits  the  injection  to 
come  in  contact  with  its  en- 
tire surface,  Instantly  dis- 
solving and  washing  out  all 
secretions     and     discharges. 


.»^^ 


The  Marvel  Company  was  awarded  the 
Gold  Medal,  Diploma  and  Certificate  of 
Approbation  by  the  Societe  D'Hyglene 
de    France,   at    Paris,    October   9,    1902. 

ALL  DRUGGISTS  AND  DEALERS  IN  SURGICAL 
INSTRUMENTS  SELL  IT. 

FOR  LITERATURE,  ADDRESS; 

Marvel    Company, 

NEV^    YORK, 


Physicians  should 
Recommend    the 
Marvel     Syringe    In 
All    Cases   of    Leu- 
corrhoea,    Vaginitis, 
And   all    Womb 
Troubles,    as    It    Is 
WARRANTED  to 
Give    Entire    Satis- 
faction. 

It  is  a 
MARVEL 


DETROIT    MEDICAL    JOURNAL 


XXV 


Dr.R.B.Waite's 

ANTISEPTIC  , 

LOCAL  ANAESTHETIC' 


JlteANTIDOLAR  NFG  C0.<S 


PRINGVILLE. 

N.Y.U.S.A, 


$1.00  BOTTLE  FREE  FOR  TRIAL 

If  you  have  not  been  so  favored  send  to  our  Depart- 
ment D,  enclosing  25  cents  for  packing  and  postage, 


The  Goodrich  Lawn 


Cf^ 


The  original  Am- 
erican-made Tennis 
Ball,  is  doing  for 
American  lawn  ten- 
nis what  the  Haskell 
Golf  Ball  has  done 
for  golf.  Officially 
approved  by  the  U. 
S.  N.  L.  T.  A.  and 
enthusiastically  en- 
dorsed by  expert 
players  as  equal  to 
,'  the  best  imported 
Tennis  Ball. 

The  GOODRICH 
is  harder  and  stays  harder  in  the  play  ;  bounds  higher 
and  truer,  cover  lasts  longer  without  ripping,  is  always 
uniform  in  quality.  Every  ball  a  tournament  ball  and 
backed  by  an  unqualified  guarantee. 


The  1905  Goodrich  Hand-Boofc  of  Lawn  Tennis  is  in- 
teresting and  a  Guide  to  the  Game>  sent  Free  on  Request, 

THE  B.  F.  GOODRICH  CO. 

Dept.  18  P.       ^       jf        AKRON,  OHIO 


Qood   News! 


Send  for  list  of  second-hand  micros- 
copes, also  announcement  of  what  is 
probably  the  most  sensational  cut  in 
prices  ever  made  on  new,  up-to-date  mi- 
croscopes of  standard  make  and  type. 
Examples:  A  microscope  complete,  with 
%  and  H  in.  objectives,  2  eye  pieces, 
iris  diaphragm,  and  case,  $31  ! !  or  with 
best  1-12  in.  oil-immersion  lens,  and 
condenser.  $70  to  $75. 


ED-WARD    PENNOCK, 

3607  Woodland  Ave.  Phlladelphis 


SAL  HEPATICA 

^■^  The  original  efferves- 
cing Saline  Laxative  and  Uric 
Acid  Solvent.  A  combination  of 
the  Tonic,  Alterative  and  Lax- 
ative Salts  similar  to  the  cele- 
brated Bitter  Waters  of  Europe, 
fortified  by  addition  of  Lithixmi 
and  Sodium  Phosphates.  It 
stimulates  liver,  tones  intes- 
tinal glands,  purifies  alimen- 
tary tract,  improves  digestion, 
assimilation  and  metabolism. 
Especially  valuable  in  rheu- 
matism, gout,  bilious  attacks, 
constipation.  Most  efficient 
in  eliminating  toxic  products 
from  intestinal  tract  or  blood, 
and  correcting  vicious  or 
impaired  functions. 

Write  for  free  samples. 
BRISTOL-MYERS  CO., 

C.'ooklyn,         New  York  City. 


XXVI 


DETROIT   MEDICAL   JOURNAL 


MEDICAL  BOOKS 

Daetrieity  in  Facial 


By  the  late  Plym  8. 
Hayes.  A.M..  M.D.,  Prof, 
of  Gynecology  and  Elec- 
tro-Therapeutics, Chica- 
go Polyclinic,  etc.  128 
pages  bound  In  cloth. 
Has  been  before  the  pro- 
fession several  years  and 
Is  still  very  popular. 
Teaches  the  Histology 
and  Pathology  of  the 
matter  as  well  as  the 
theory  and  application  of 
Electrolysis  In  epilation 
and  removal  of  moles. 
Price,  postpaid.  $1.00 

TiM  Sidn :  Its  Cart  and 


A  very  helpful  vol- 
ume of  246  pages  sub- 
stantially bound  In  cloth. 
Contains  29  full  page 
half-tone  plates  showing 
the  manner  of  procedure 
In  i:iectrlc  Scalp  and 
Facial  Massage,  the  re- 
moval of  blemishes  such 
as  Superfluous  Hair, 
Moles,  and  Warts,  by 
Electrolysis,  the  treat- 
ment of  blackheads, 
pimples,  etc. 
31  Instructive  Chapters 

Price  Postpaid,  $1.50 


Mcintosh  Univer- 
sal Wall  Cabinet 

No.  8 

The  most  elaborate 
and  complete  outfit  ever 
offered  to  the  profession, 
embracing  all  features  of 
a  ttrst  class  office  switch- 
board. It  may  be  operat- 
ed in  connection  with 
either  direct  or  alternat- 
ing current  and  gives  Gal- 
vanic, High  Tension  Far- 
adic.  Sinusoidal.  Cautery 
and  Diagnostic  Lamp  Cur- 
rents. A  multiplicity  of 
combined  currents  is  of- 
fered by  our  new  Current 
Combiner  Switch.  A  sep- 
arate circuit  is  provided 
for  diagnostic  lamps. 

The  cautery  current  is 
obtained  from  the  light- 
ing circuit  and  the  sinu- 
soidal current  is  secured 
from  direct  as  well  as 
alternating  circuits.  This 
outfit  offers  a  range  of 
effects  not  heretofore 
obtained  except  from 
very  costly  apparatus, 
and  at  a  price  within 
reach  of  all. 

We  have  a  full  line  of  Wall 
Cabinets,  some  as  ^m^  en 
low  as $40.50 


A  NEW  JOURNAL 


"The 

A  very  up  -  to  -  date 
little  periodical  giving 
very  valuable  matter  on 
the  subject  of  electro- 
therapy, covering  the 
mechanical  side  as  well 
as  the  therapeutic  feat- 
ures. During  the  year 
19<»5  a  number  of  articles 
from  the  pen  of  Dr.  C.  S. 
NelBwanger  will  appear 
in  our  columns.  No  pains 
will  be  spared  to  make 
this  Journal  attractive 
and  Interesting  to  the 
reader,  and  we  bespeak 
the  hearty  support  of  all 
who  use  electricity  In 
medicine.  Subscription 
price  placed  for  a  brief 
period  at  26e  Per  Annum. 
Ask  for  Sample  Copy 


SOMETHING  NEW  I 


Q 


No.  95  Neiswanger's 
Vaginal  Eleotrode 

A  one  Inch  perforat- 
ed copper  ball  mounted 
on  an  Insulated  brass 
tube  nine  Inches  In 
length.  Useful  In  Gal- 
vanization,Faradization, 
Metallic  Electrolysis, 
Cataphoresls  or  Irriga- 
tion. Recently  sold  at 
$3.00,  now  priced  at 
$2.25  postpaid. 


OUR  NEW  CATALOGUE  No.  26  S  shows  REDUCED  PRICES  on  all  of    Mfklnfneh    DaffAt^   A   nntirol    On 
our  standard  goods  as  well  as  a  number  o^  new  and  pleasing  designs  In    Ifll#llllU5>ll    BCillvl  J    i«   V|lllwai    VV« 


Batterles.Wall  Plates,  Electrodes,  Cautery  Transformers,  Static  Machines, 
High  Frequency  Apparatus,  etc.    Mailed  free  upon  request. 


6-8  North  Canal  St.,  Chicago,  III. 


SILFODINE 

(C,o  H,3)  atlS  2I 

Sulplitir  13%    Iodine  27% 
Base-THymol 

Odorless  Non-Irritating 

Non-Staining 


From  this  loose  chemical  compound  are 
liberated  Sulphur  (in  the  form  of  sulphurous 
acid,)  and  Iodine  in  its  nascent  state,  thus  pro- 
viding for  the  exhibition  of  a  true  germicide 
and  a  cell  stimulant  in  one. 

INDICA.TION5 

In  the  Powder  form:  in  all  lesions  in  which 
suppuration  is  taking  place,  as  in  ulcers,  bed 
sores,  infected  wounds,  etc. 

In  the  Ointment  form,  with  lanolin ;  in  the 
treatment  of  Eczema,  Pruritus,  Seborrhea, 
Scabies,  etc. 

Also  prepared  in  the  form  of  urethral  pencils, 
vaginal  suppositories,  and  2  gr.  tablets. 

To  members  of  the  Medical  Profession  we 
are  most  happy  to  submit  specimens  and  de- 
tailed information. 


CHexnical  Prodti<5ls  Co. 

Detroit 


Medicine  Case  ?1^J!^ 
PR.ICE:.  $10.50 

Dimensions:  11  inches  long,  6  inches 
wide  and  6  inches  high. 

Made  entirely  of  heavy  harness 
leather,  hand  stitched  around  the  edges 
and  full   leather  lined. 

It  contains  24  one  ounce,  24  three 
dram  and  3  three  ounce  C.  S.  bottles, 
also,  4  two  ounce  G.  S.  and  M.  C.  bottles 
and   supply   space   10^x51/^x1%    inches. 

Pitted  with  the  "Western"  silver-plat- 
ed springs  for  holding  bottles,  "Western 
safety  lock  and  strong  handle. 

The  highest  grade  case  made  by  us. 

Send  for  complete  catalogue 

'WKSTILV.N  I^CATHER.  MFG.  CO., 
46  'WrabasK  A.ve..  CHica^o 


DETROIT    MEDICAL    JOURNAL 


XXVII 


Reasons  iSpenccr  Microscopes 


Why 


i 


Are  to  be  Preferred. 


They   represent   methods  of  utmost  precision 

in  mechanical  construction. 

They  combine  steadiness,  durability,  a  pleaS" 
^p^  ing   symmetry   of   proportions,   a   more   con- 

^^m  venient  height  for  the  eye  and  great  beauty 

^S/  of  finish. 

The  lower  parts  are  heavily  coated  with  a  gun 

metal  plating  which  resists  solvents. 

The  patented  fine  adjustment     is     absolutely 

dust-proof. 

Our  objectives  are  always     carefully     tested 

and  are  very  uniform.     We    guarantee    them 

unsurpassed,  grade  for  grade    by    any    in   the 

world. 

Send  for  description  and  prices. 


^Spencer  Lens  Co. 

BUFFALO,  N.  Y. 


ALBASULPHIDI 

The  only  reliable  lotion  for  the  prompt  and 
effectual  eradication  of  Acne  in  all 
its   protean  forms  — Guaranteed  I 

(formula  of  o.  k.  shimmbl.) 

This  preparation  represents  the  greatest  possible  therapeutic 
activity,  together  with  the  perfection  of  pharmaceutical  art  and  chem- 
ical skill.     In  pint  bottles  only. 

EACH  PINT  SUFFICES  FOR  FOUR  PRESCRIPTIONS. 

Phicb:    75  Cbmts  m  Bottlb,  Net. 


HARTZ  ACNE  lANCE  AND  COMEDO  EXTRACTOR. 


Price:    25  Ckmts  Each. 


^ 


TUC      I       C      U  A  DTT    Pf%        '^^  ^'^^  '^^  Miami  Ave.,  Detroit,  Micli. 
I  lIL    J.     I  •     n AK  I  L    LU«       No.  2,  East  Richmond  St.,  Toronto,  Ont. 


XXVIII 


DETROIT    MEDICAL    JOURNAL 


The  Physician  of  Many  Years  Experience 

kr\ows   tKait  throvigK  a^II  tKe 
waves  of  cKa^n^e  arvd  progress 


r\o  remedy  is  so  widely  \jsed  by  the 
profession  or  held  irvsvicK  high  favor  as 


IN  the:  rjR£;ATM£^NT  or 

j9M£M/A^fi//MS7?f£m,3mNC/f/m/AfFli/£NZA 
Pl/im/VA/fy  Tl/BfffCUL03/S  AM)  tmTW6m£AS£S  Of 
CmD/fOOaMDDi/ffm  C0W/IL£SC£NC£ 
ffiOAf£X/Ml/Sr/mD/S£A6£S, 

ft  starvcis  without  ac  peer;  a^dvertised 
only  to  the  rr\edicaul   profession^ 
is  on  s^Ie  in  every  DAj^  Store 
^^  in  the  United  Ste^tes 

MR,  FELLOWS 


26  CHRISTOPHER  STREET   NEW  YORK. 


6>6c  Jackson  Coil 
is    unexcelled 

For  High  Frequency  and  X-Ray  work 
— Absolute  Control — Splendid  Effleuve 
— P  erfect     Reliability 

For   Particulars^   send  for   Bulletin  D. 

SWETT  ®L  LEWIS 
COMPANY 


18      BOYLSTON      STREET 
Boston,     Massachusetts 


SODIIM  SALICYLATE 

TRIE  FROM  NATURAL  WINTERGREEN  OIL 


In  perfecting  their  products  from  Natural  Wintergreen  Oil  and  in 
demonstrating  their  therapeutic  value,  the  Merrell  Company  have  won 
the  confidence  of  the  medical  profession  and  established  the  fact  that 
Natural  Salicylates  should  alone  be  employed  for  internal  administra- 
tion; and  when  Sodium  Salicylate,  true,  is  specified,  it  is  clearly  the 
desire  of  the  physician  that  the  Merrell  product  should  be  used.  The 
only  recommendation  of  other  brands  is  that  "they  are  cheaper  in  price,'' 
and  it  is  such  substitution  which  often  convinces  the  physician  that  it 
is  necessary  for  him  to  dispense  his  own  medicines. 

In  addition  to  the  powdered  and  crystalline  forms  Sodium  Salicy- 
late, true,  is  offered  in  2^  and  5  grain  compressed  tablets. 

No  Increase  in  Price.  These  tablets  are  put  up  in  i  oz.,  34  lb., 
Yi  lb.  and  i  lb.  bottles,  and  are  sold  at  the  same  price  as  the  powder. 

The  Merrell  Company  were  the  first,  and  are  now  the  only,  man- 
ufacturers in  the  United  States  of  these  Natural  Educts  from  Winter- 
green,  and  their  product  should  always  be  used  if  undesirable  com- 
plications are  to  be  avoided. 

Our  72-page  booklet  upon  this  subject  is  sent  free  upon  application. 


RHEUMATISM 


In  the  treatment  of  Rheumatism,  Elimination  and  Salicylic  Acid 
rarely 'fail  to  give  the  best  result.  Keep  the  bowels  open  and  the 
kidneys  active  by  means  of  salines  and  the  ingestion  of  large  quantities 
of  pure  water  (this  also  favors  diaphoresis)  and  Ferro  Salicylata 
(Merrell)   will  do  the  rest. 

Ferro  Salicylata  contains,  in  each  fluid  dram,  five  grains  of  Salicy- 
lic Acid  and  five  mmims  of  the  Tincture  Citro-Chlorid  of  Iron;  as  the 
True  Acid  from  Natural  Wintergreen  Oil  is  used,  the  preparation  is 
devoid  of  those  depressing  effects  which  so  often  attend  the  administra- 
tion of  the  synthetic  product,  and  it .  may,  therefore,  be  given  in  as 
large  and  as  frequently  repeated  doses  as  are  indicated  to  control  the 
symptoms    and    cure  the  patient. 

As  a  tonic  after  Grip,  Ferro  Salicylata  will  do  more  toward  restor- 
ing the  strength  of  the  patient  than  all  other  remedies  combined,  and 
for  the  depressed  condition  which  so  often  attends  convalescence  after 
Grip,  Ferro  Salicylata  is  almost  a  specific. 

Ferro   Salicylata  is  carried  in  stock  by  all  Prescription  Pharmacists. 

Send  for  descriptive  circular  matter  and  complete  catalogue  of 
pharmaceutical    preparations. 


TIWM.  S.  MERRELL  CHEMICAL  CO., 

— = — = — =  CINCINNATI  = — == — = 


Awarded 
GOLD  MEDAL 

Louisiana 
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THe    Standard  Antiseptic 

LISTERINE 


Awarded 
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A  non-toxic  antiseptic  of  known  and  definite  power,  pre- 
pared in  a  form  convenient  for  immediate  use,  of  ready  dilution, 
sightly,  pleasant,  and  sufficiently  powerful  for  all  purposes  of 
asepsis.     These  are  advantages  which  Listerine  embodies. 

The  success  of  Listerine  is  based  upon  merit,  and  the 
best  advertisement  of  Listerine  is — Listerine. 


LISTERINE 

DERMATIC    SOAP 

An.    antiseptic    determent   for   use    in    tHe    antiseptic 
treatment   of  diseases    of  tHe  sKin. 


Listerine  "  Dermatic "  Soap  contains  the  essential  antiseptic  constituents 
of  eucalyptus  (1%),  mentha,  gaultheria  and  thyme  (each  )^^),  which  enter 
into  the  composition  of  the  well-known  antiseptic  preparation,  Listerine,  while 
the  quality  of  excellence  of  the  soap-stock  employed  as  the  vehicle  for 
this  medication,  will  be  readily  apparent  when  used  upon  the  most  delicate 
skin,  and  upon  the  scalp.  Listerine  "  Dermatic "  Soap  contains  no  animal 
fats,  and  none  but  the  very  best  vegetable  oils ;  after  its  manufacture,  and  be- 
fore it  is  "milled"  and  pressed  into  cakes  a  high  percentage  of  an  emollient 
oil  is  incorporated  with  the  soap,  and  the  smooth,  elastic  condition  of  the  skin 
secured  by  using  Listerine  "  Dermatic  "  Soap  is  largely  due  to  the  presence  of  this 
ingredient.  Unusual  care  is  exercised  in  the  preparation  of  Listerine  "Der- 
matic" Soap,  and  as  the  antiseptic  constituents  of  Listerine  are  added  to  the 
soap  after  it  has  received  its  surplus  of  unsaponified  emollient  oil,  they  retain 
their  peculiar  antiseptic  virtues  and  fragrance. 


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GOLD  MEOAL 

Louisiana 
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Exposition 


A   sam|)le  of  Listerine  Dermatic  Soat>  may   be  had  ut>on 
a|)|)licatioD  to  the  Manufacturers— 

I^ambert    PHarinacal 
Oompany,  st.  i^ouis.  u.  s.  a. 


Awarded 
GOLD  MEDAL 

Louisiana 
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